INDIANA UNIVERSITY HEALTH NORTH HOSPITAL INC: Form 990, tax year 2016

View the entire original 990 at ProPublica ↗

Organization: INDIANA UNIVERSITY HEALTH NORTH HOSPITAL INC (EIN 35-1932442)
Tax period: 2016-01-01 to 2016-12-31
Filed: 2017-11-15
IRS object ID: 201713199349301761
Schema version: 2016v3.1
Source: Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header
Form 990
Schedule A
Schedule B
Schedule C
Schedule D
Schedule G
Schedule H
Schedule I
Schedule J
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2017-11-15T07:39:34-06:00	ReturnTs
Tax Period End	2016-12-31	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	ERNST & YOUNG US LLP	BusinessNameLine1Txt

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	111 MONUMENT CIRCLE SUITE 4000	AddressLine1Txt
City	INDIANAPOLIS	CityNm
State Abbreviation	IN	StateAbbreviationCd
ZIP	46204	ZIPCd

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2016-01-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	351932442	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	INDIANA UNIVERSITY HEALTH NORTH HOSPITAL	BusinessNameLine1Txt
Business Name Line2	INC	BusinessNameLine2Txt

Field	Value	IRS element (for citing)
In Care Of	% SEAN M BARR	InCareOfNm
Business Name Control	INDI	BusinessNameControlTxt
Phone	3179624112	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	950 N MERIDIAN STREET SUITE 300	AddressLine1Txt
City	INDIANAPOLIS	CityNm
State Abbreviation	IN	StateAbbreviationCd
ZIP	46204	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	RANDALL C YUST	PersonNm
Person Title	TREASURER/COO/CFO	PersonTitleTxt
Phone	3179624112	PhoneNum
Signature	2017-11-14	SignatureDt

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	JENNIFER D RHODERICK	PreparerPersonNm
PTIN	P00395735	PTIN
Phone	3176817000	PhoneNum

Filing Security Information FilingSecurityInformation

IP Address IPAddress

Field	Value	IRS element (for citing)
I Pv4 Address	162.1.129.128	IPv4AddressTxt

Field	Value	IRS element (for citing)
Federal Original Submission Id	35668520173195000012	FederalOriginalSubmissionId
Federal Original Submission Id	2017-11-15	FederalOriginalSubmissionIdDt
Filing License Type	P	FilingLicenseTypeCd
At Submission Creation Device Id	49A42BAE7DB19B68098C55D96BB751E89F2C86F0	AtSubmissionCreationDeviceId
At Submission Filing Device Id	49A42BAE7DB19B68098C55D96BB751E89F2C86F0	AtSubmissionFilingDeviceId

Field	Value	IRS element (for citing)
Tax	2016	TaxYr
Build TS	2017-02-10 21:41:12Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Address Change	Yes (X)	AddressChangeInd
Principal Officer	JONATHAN R GOBLE	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	950 N MERIDIAN ST STE 300	AddressLine1Txt
City	INDIANAPOLIS	CityNm
State Abbreviation	IN	StateAbbreviationCd
ZIP	46204	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$247,172,784	GrossReceiptsAmt
Group Return For Affiliates	false	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	HTTP://IUHEALTH.ORG/NORTH/	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1994	FormationYr
Legal Domicile State	IN	LegalDomicileStateCd
Activity Or Mission	Improve the health of our communities, support the educational commitment of Indiana University Health, Inc., nurture the indvidual spirit, and celebrate the experiences of life.	ActivityOrMissionDesc
Voting Members Governing Body	11	VotingMembersGoverningBodyCnt
Voting Members Independent	5	VotingMembersIndependentCnt
Total Employee	1236	TotalEmployeeCnt
Total Volunteers	100	TotalVolunteersCnt
Total Gross UBI	$97,464	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$86,718	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$267,036	PYContributionsGrantsAmt
CY Contributions Grants	$65,690	CYContributionsGrantsAmt
PY Program Service Revenue	$230,957,489	PYProgramServiceRevenueAmt
CY Program Service Revenue	$242,852,672	CYProgramServiceRevenueAmt
PY Investment Income	$1,001,223	PYInvestmentIncomeAmt
CY Investment Income	$636,831	CYInvestmentIncomeAmt
PY Other Revenue	$3,365,072	PYOtherRevenueAmt
CY Other Revenue	$3,503,627	CYOtherRevenueAmt
PY Total Revenue	$235,590,820	PYTotalRevenueAmt
CY Total Revenue	$247,058,820	CYTotalRevenueAmt
PY Grants And Similar Paid	$0	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$93,987	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$64,898,076	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$67,336,412	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$189,166	CYTotalFundraisingExpenseAmt
PY Other Expenses	$119,672,977	PYOtherExpensesAmt
CY Other Expenses	$123,731,175	CYOtherExpensesAmt
PY Total Expenses	$184,571,053	PYTotalExpensesAmt
CY Total Expenses	$191,161,574	CYTotalExpensesAmt
PY Revenues Less Expenses	$51,019,767	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$55,897,246	CYRevenuesLessExpensesAmt
Total Assets BOY	$385,806,663	TotalAssetsBOYAmt
Total Assets EOY	$435,171,691	TotalAssetsEOYAmt
Total Liabilities BOY	$240,487,124	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$233,954,906	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$145,319,539	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$201,216,785	NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part III	Yes (X)	InfoInScheduleOPartIIIInd
Mission	IMPROVE THE HEALTH OF OUR COMMUNITIES, SUPPORT THE EDUCATIONAL COMMITMENT/EFFORTS OF INDIANA UNIVERSITY HEALTH, INC. ("IU HEALTH"), NURTURE THE INDIVIDUAL SPIRIT, AND CELEBRATE THE EXPERIENCES OF LIFE.	MissionDesc
Significant New Program Srvc	false	SignificantNewProgramSrvcInd
Significant Change	false	SignificantChangeInd
Expense	$166,212,313	ExpenseAmt
Grant	$93,987	GrantAmt
Revenue	$242,852,672	RevenueAmt
Desc	Indiana University Health North Hospital, Inc. ("IU Health North Hospital") has provided leading family-centered care to Carmel and Hamilton County residents since 2005. As a full-service hospital for adults and children with an attached medical office building, IU Health North Hospital brings together physician offices, 189 inpatient beds, and operating rooms in a state-of-the-art facility where compassionate caregivers provide superior patient treatment without regard to a patients ability to pay. All patient rooms are private to optimize comfort for each individual and their family, and our wealth of services for adults and children ranges from cardiovascular and orthopedic care to maternity and cancer care. As part of our commitment to fostering the health of our communities, we are proud to also offer the peace of mind that comes with the service and support of Riley Hospital for Childrens nationally recognized programs. Throughout our facility, you will be introduced to the innovative technology, the outstanding amenities and extraordinary service culture that make up the atmosphere of total healing of a patients mind, body and spirit. However, that only scratches the surface of what makes IU Health North Hospital unique. Through rich community involvement, we have taken seriously IU Healths pledge to enrich the lives of those we serve with a variety of free screenings and seminars aimed at giving you the tools needed to live a healthier, more active life.	Desc
Total Program Service Expenses	$166,212,313	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (true)	DescribedInSection501c3Ind
Schedule B Required	Yes (true)	ScheduleBRequiredInd
Political Campaign Acty	false	PoliticalCampaignActyInd
Lobbying Activities	Yes (true)	LobbyingActivitiesInd
Subject To Proxy Tax	false	SubjectToProxyTaxInd
Donor Advised Fund	false	DonorAdvisedFundInd
Conservation Easements	false	ConservationEasementsInd
Collections Of Art	false	CollectionsOfArtInd
Credit Counseling	false	CreditCounselingInd
Temp Or Permanent Endowments	false	TempOrPermanentEndowmentsInd
Report Land Building Equipment	Yes (true)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	false	ReportInvestmentsOtherSecInd
Report Program Related Invst	false	ReportProgramRelatedInvstInd
Report Other Assets	false	ReportOtherAssetsInd
Report Other Liabilities	Yes (true)	ReportOtherLiabilitiesInd
Include FIN48 Footnote	Yes (true)	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	false	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	Yes (true)	ConsolidatedAuditFinclStmtInd
School Operating	false	SchoolOperatingInd
Foreign Office	false	ForeignOfficeInd
Foreign Activities	false	ForeignActivitiesInd
More Than5000 K To Org	false	MoreThan5000KToOrgInd
More Than5000 K To Individuals	false	MoreThan5000KToIndividualsInd
Professional Fundraising	false	ProfessionalFundraisingInd
Fundraising Activities	Yes (true)	FundraisingActivitiesInd
Gaming Activities	false	GamingActivitiesInd
Operate Hospital	Yes (true)	OperateHospitalInd
Audited Financial Stmt Att	Yes (true)	AuditedFinancialStmtAttInd
Grants To Organizations	Yes (true)	GrantsToOrganizationsInd
Grants To Individuals	Yes (true)	GrantsToIndividualsInd
Schedule J Required	Yes (true)	ScheduleJRequiredInd
Tax Exempt Bonds	false	TaxExemptBondsInd
Engaged In Excess Benefit Trans	false	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	false	PYExcessBenefitTransInd
Loan Outstanding	false	LoanOutstandingInd
Grant To Related Person	false	GrantToRelatedPersonInd
Business Rln With Org Mem	false	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	false	BusinessRlnWithFamMemInd
Business Rln With Officer Ent	false	BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri	false	DeductibleNonCashContriInd
Deductible Art Contribution	false	DeductibleArtContributionInd
Terminate Operations	false	TerminateOperationsInd
Partial Liquidation	false	PartialLiquidationInd
Disregarded Entity	false	DisregardedEntityInd
Related Entity	Yes (true)	RelatedEntityInd
Related Organization Ctrl Ent	Yes (true)	RelatedOrganizationCtrlEntInd
Transaction With Control Ent	Yes (true)	TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	false	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	false	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (true)	ScheduleORequiredInd
IRP Document	68	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (true)	BackupWthldComplianceInd
Employee	1236	EmployeeCnt
Employment Tax Returns Filed	Yes (true)	EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit	Yes (true)	UnrelatedBusIncmOverLimitInd
Form990 T Filed	Yes (true)	Form990TFiledInd
Foreign Financial Account	false	ForeignFinancialAccountInd
Prohibited Tax Shelter Trans	false	ProhibitedTaxShelterTransInd
Taxable Party Notification	false	TaxablePartyNotificationInd
Nondeductible Contributions	false	NondeductibleContributionsInd
Quid Pro Quo Contributions	Yes (true)	QuidProQuoContributionsInd
Quid Pro Quo Contri Discl	Yes (true)	QuidProQuoContriDisclInd
Form8282 Property Disposed Of	false	Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct	false	RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct	false	PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services	false	IndoorTanningServicesInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	11	GoverningBodyVotingMembersCnt
Independent Voting Member	5	IndependentVotingMemberCnt
Family Or Business Rln	Yes (true)	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	false	DelegationOfMgmtDutiesInd
Change To Org Documents	false	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	false	MaterialDiversionOrMisuseInd
Members Or Stockholders	Yes (true)	MembersOrStockholdersInd
Election Of Board Members	Yes (true)	ElectionOfBoardMembersInd
Decisions Subject To Approva	Yes (true)	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (true)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (true)	MinutesOfCommitteesInd
Officer Mailing Address	false	OfficerMailingAddressInd
Local Chapters	false	LocalChaptersInd
Form990 Provided To Gvrn Body	Yes (true)	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (true)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (true)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (true)	RegularMonitoringEnfrcInd
Whistleblower Policy	Yes (true)	WhistleblowerPolicyInd
Document Retention Policy	Yes (true)	DocumentRetentionPolicyInd
Compensation Process CEO	false	CompensationProcessCEOInd
Compensation Process Other	Yes (true)	CompensationProcessOtherInd
Investment In Joint Venture	false	InvestmentInJointVentureInd
States Where Copy Of Return Is Fld	IN	StatesWhereCopyOfReturnIsFldCd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Field	Value	IRS element (for citing)
Person	SEAN M BARR	PersonNm
Phone	3179624112	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	950 N MERIDIAN ST STE 800	AddressLine1Txt
City	INDIANAPOLIS	CityNm
State Abbreviation	IN	StateAbbreviationCd
ZIP	46204	ZIPCd

Field	Value	IRS element (for citing)
Info In Schedule O Part VII	Yes (X)	InfoInScheduleOPartVIIInd

Form990 Part VII Section A Form990PartVIISectionAGrp (27 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	OfficerOfficerInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	Key EmployeeKeyEmployeeInd	Highest Compensated EmployeeHighestCompensatedEmployeeInd	Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
CHARLES E SCHALLIOL
CHAIRMAN	5.0	0.0	Yes (X)	Yes (X)	$10,500	$0	$0
JONATHAN R GOBLE
DIRECTOR/PRESIDENT & CEO	0.0	55.0	Yes (X)	Yes (X)	$0	$606,081	$120,422
JOHN D GOLDENBERG MD
DIRETOR/PHYSICIAN	8.0	0.0	Yes (X)		$14,400	$0	$0
MICHAEL N TSANGARIS MD
DIRECTOR/PHYSICIAN (PART. YR.)	5.0	55.0	Yes (X)		$4,500	$159,202	$11,201
MATTHEW R COOK
DIRECTOR	5.0	55.0	Yes (X)		$0	$652,302	$94,431
JAMES R CUMMING MD
DIRECTOR	5.0	0.0	Yes (X)		$3,750	$0	$0
DANIEL F EVANS JR
DIRECTOR	5.0	55.0	Yes (X)		$0	$1,523,416	$274,557
ROBERT E EVARD MD
DIRECTOR	5.0	55.0	Yes (X)		$0	$76,951	$0
ADAM M HORST
DIRECTOR (PARTIAL YEAR)	5.0	55.0	Yes (X)		$0	$353,479	$21,850
MICHELE M KAWIECKI
DIRECTOR	5.0	0.0	Yes (X)		$6,000	$0	$0
MICHAEL L KUBACKI
DIRECTOR	5.0	0.0	Yes (X)		$6,000	$0	$0
MARK A LANTZY
DIRECTOR	5.0	55.0	Yes (X)		$0	$409,023	$99,627
GLENN SCOLNIK
DIRECTOR	5.0	0.0	Yes (X)		$5,250	$0	$0
STEVEN L WANTZ
DIRECTOR (PARTIAL YEAR)	5.0	55.0	Yes (X)		$0	$646,847	$115,230
JEROME P KELLY
SECRETARY (PARTIAL YEAR)	0.0	55.0		Yes (X)	$0	$196,412	$20,834
DEREK E EMPIE
SECRETARY	0.0	55.0		Yes (X)	$0	$173,787	$37,304
RANDALL C YUST
TREASURER/COO/CFO	0.0	55.0		Yes (X)	$0	$310,070	$32,578
PAUL M CALKINS MD
VP & CMO	55.0	0.0			$411,938	$0	$35,011	Yes (X)
SUZANNE M DELBOCCIO RN
VP & CNO (PARTIAL YEAR)	55.0	0.0			$215,947	$0	$17,232	Yes (X)
RUTH A KAIN RN
VP & CNO	55.0	0.0			$166,586	$0	$31,223	Yes (X)
SHELDON G WEISS MD
CHIEF STRATEGY OFFICER	55.0	0.0			$416,172	$0	$41,259		Yes (X)
MICHAEL L HARLOWE
PRESIDENT (TIPTON & SAXONY)	55.0	0.0			$276,426	$0	$32,077		Yes (X)
MARK A MCLEAN
DIRECTOR, OPERATIONS	55.0	0.0			$191,333	$0	$24,552		Yes (X)
LINDA S DECKER RN
TRANSFORMATION OFFICER	55.0	0.0			$183,097	$0	$16,947		Yes (X)
PAMELA V LOWE RN
DIRECTOR, QUALITY	55.0	0.0			$166,535	$0	$35,372		Yes (X)
CHARLES M SHUFFLEBARGER MD
FORMER PRESIDENT	0.0	55.0			$0	$360,288	$17,483			Yes (X)
ANN L ESKEW RN
FORMER DIRECTOR, RILEY-NORTH	0.0	55.0			$0	$121,755	$13,964			Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$2,078,434	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$5,589,613	TotReportableCompRltdOrgAmt
Total Other Compensation	$1,093,154	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	43	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	Yes (true)	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (true)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	false	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1Txt	CityContractorAddress/USAddress/CityNm	State AbbreviationContractorAddress/USAddress/StateAbbreviationCd	ZIPContractorAddress/USAddress/ZIPCd	ServicesServicesDesc	CompensationCompensationAmt
ARAMARK HEALTHCARE TECHNOLOGIES
10510 TWIN LAKES PARKWAY	CHARLOTTE	NC	28269	CLINICAL ENGINEERING	$2,537,416
MEDEFIS CONSOLIDATED
PO BOX 5068	NEW YORK	NY	10087	STAFFING	$1,289,818
SODEXO INC AFFILIATES
4880 PAYSPHERE CIRCLE	CHICAGO	IL	60674	FACILITIES	$929,016
UNITED HOSPITAL SERVICES LLC
9948 PARK DAVIS DR	INDIANAPOLIS	IN	46235	LAUNDRY	$525,928
IRRIGATION PLUS
22918 MULEBARN ROAD	SHERIDAN	IN	46069	LANDSCAPING	$518,389

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	13	CntrctRcvdGreaterThan100KCnt
Info In Schedule O Part VIII	Yes (X)	InfoInScheduleOPartVIIIInd
Fundraising	$14,816	FundraisingAmt
All Other Contributions	$50,874	AllOtherContributionsAmt
Total Contributions	$65,690	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (3 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
NET PATIENT SERVICE REVENUE	621110	$238,808,732	$238,808,732
SHARED SERVICES	541990	$3,372,859	$3,372,859
RENT FROM RELATED 501(C)(3) ORGS.	532000	$671,081	$671,081

Field	Value	IRS element (for citing)
Total Program Service Revenue	$242,852,672	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$372,195	TotalRevenueColumnAmt
Exclusion	$372,195	ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Royalties Revenue RoyaltiesRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Gross Rents GrossRentsGrp

Field	Value	IRS element (for citing)
Real	$127,036	RealAmt

Less Rental Expenses LessRentalExpensesGrp

Field	Value	IRS element (for citing)
Real	$42,970	RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	$84,066	RealAmt
Personal	$0	PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$84,066	TotalRevenueColumnAmt
Exclusion	$84,066	ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Other	$326,082	OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

Field	Value	IRS element (for citing)
Other	$61,446	OtherAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Other	$264,636	OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$264,636	TotalRevenueColumnAmt
Exclusion	$264,636	ExclusionAmt

Field	Value	IRS element (for citing)
Fundraising Gross Income	$30,430	FundraisingGrossIncomeAmt
Contri Rpt Fundraising Event	$14,816	ContriRptFundraisingEventAmt
Fundraising Direct Expenses	$9,548	FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$20,882	TotalRevenueColumnAmt
Exclusion	$20,882	ExclusionAmt

Field	Value	IRS element (for citing)
Gaming Gross Income	$0	GamingGrossIncomeAmt
Gaming Direct Expenses	$0	GamingDirectExpensesAmt

Net Income From Gaming NetIncomeFromGamingGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Field	Value	IRS element (for citing)
Gross Sales Of Inventory	$0	GrossSalesOfInventoryAmt
Cost Of Goods Sold	$0	CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Unrelated Business RevenueUnrelatedBusinessRevenueAmt	ExclusionExclusionAmt
CAFETERIA/FOOD SERVICE	721110	$2,514,595	$97,464	$2,417,131
EDUCATION	900099	$68,767		$68,767
VENDING	900099	$5,717		$5,717

Miscellaneous Revenue MiscellaneousRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$809,600	TotalRevenueColumnAmt
Exclusion	$809,600	ExclusionAmt

Field	Value	IRS element (for citing)
Other Revenue Total	$3,398,679	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$247,058,820	TotalRevenueColumnAmt
Related Or Exempt Func Income	$242,852,672	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$97,464	UnrelatedBusinessRevenueAmt
Exclusion	$4,042,994	ExclusionAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part IX	Yes (X)	InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

Field	Value	IRS element (for citing)
Total	$85,000	TotalAmt
Program Services	$85,000	ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

Field	Value	IRS element (for citing)
Total	$8,987	TotalAmt
Program Services	$8,987	ProgramServicesAmt

Foreign Grants ForeignGrantsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Benefits To Members BenefitsToMembersGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$928,337	TotalAmt
Program Services	$829,218	ProgramServicesAmt
Management And General	$99,119	ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$53,736,556	TotalAmt
Program Services	$47,878,573	ProgramServicesAmt
Management And General	$5,737,494	ManagementAndGeneralAmt
Fundraising	$120,489	FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$1,831,869	TotalAmt
Program Services	$1,632,172	ProgramServicesAmt
Management And General	$195,590	ManagementAndGeneralAmt
Fundraising	$4,107	FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$6,893,977	TotalAmt
Program Services	$6,142,444	ProgramServicesAmt
Management And General	$736,075	ManagementAndGeneralAmt
Fundraising	$15,458	FundraisingAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$3,945,673	TotalAmt
Program Services	$3,515,543	ProgramServicesAmt
Management And General	$421,283	ManagementAndGeneralAmt
Fundraising	$8,847	FundraisingAmt

Fees For Services Management FeesForServicesManagementGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

Field	Value	IRS element (for citing)
Total	$7,402	TotalAmt
Management And General	$7,402	ManagementAndGeneralAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$41,158,725	TotalAmt
Program Services	$39,564,198	ProgramServicesAmt
Management And General	$1,576,371	ManagementAndGeneralAmt
Fundraising	$18,156	FundraisingAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$260,011	TotalAmt
Program Services	$238,561	ProgramServicesAmt
Management And General	$16,450	ManagementAndGeneralAmt
Fundraising	$5,000	FundraisingAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$3,810,785	TotalAmt
Program Services	$3,567,320	ProgramServicesAmt
Management And General	$243,075	ManagementAndGeneralAmt
Fundraising	$390	FundraisingAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$267,976	TotalAmt
Program Services	$259,767	ProgramServicesAmt
Management And General	$8,209	ManagementAndGeneralAmt

Royalties RoyaltiesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$8,665,389	TotalAmt
Program Services	$1,906,969	ProgramServicesAmt
Management And General	$6,758,420	ManagementAndGeneralAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$37,502	TotalAmt
Program Services	$24,804	ProgramServicesAmt
Management And General	$11,336	ManagementAndGeneralAmt
Fundraising	$1,362	FundraisingAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$30,399	TotalAmt
Program Services	$14,801	ProgramServicesAmt
Management And General	$15,598	ManagementAndGeneralAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$13,991,672	TotalAmt
Program Services	$13,991,672	ProgramServicesAmt

Payments To Affiliates PaymentsToAffiliatesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$9,018,815	TotalAmt
Program Services	$3,752,751	ProgramServicesAmt
Management And General	$5,266,064	ManagementAndGeneralAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$1,315,120	TotalAmt
Program Services	$278,537	ProgramServicesAmt
Management And General	$1,036,583	ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt
DRUGS AND MEDICAL SUPPLIES	$31,469,378	$31,469,378
BAD DEBT	$3,989,925	$3,989,925
INSTITUTIONAL DUES/LICENSES	$100,058	$100,058
HOSPITAL ASSESSMENT FEE	$6,759,098	$6,759,098

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$2,848,920	TotalAmt
Program Services	$202,537	ProgramServicesAmt
Management And General	$2,631,026	ManagementAndGeneralAmt
Fundraising	$15,357	FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$191,161,574	TotalAmt
Program Services	$166,212,313	ProgramServicesAmt
Management And General	$24,760,095	ManagementAndGeneralAmt
Fundraising	$189,166	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$12,609	BOYAmt
EOY	$15,700	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$214,118,940	BOYAmt
EOY	$261,849,750	EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$30,006,546	BOYAmt
EOY	$34,662,281	EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

Field	Value	IRS element (for citing)
BOY	$644,011	BOYAmt
EOY	$1,280,553	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$2,491,498	BOYAmt
EOY	$2,379,762	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$854,815	BOYAmt
EOY	$948,190	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$270,736,065	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$136,700,610	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$137,678,244	BOYAmt
EOY	$134,035,455	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Intangible Assets IntangibleAssetsGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$385,806,663	BOYAmt
EOY	$435,171,691	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$16,116,980	BOYAmt
EOY	$14,854,339	EOYAmt

Grants Payable GrantsPayableGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Deferred Revenue DeferredRevenueGrp

Field	Value	IRS element (for citing)
BOY	$1,231,792	BOYAmt
EOY	$929,053	EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$223,138,352	BOYAmt
EOY	$218,171,514	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$240,487,124	BOYAmt
EOY	$233,954,906	EOYAmt

Field	Value	IRS element (for citing)
Organization Follows SFAS117	Yes (X)	OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$145,319,539	BOYAmt
EOY	$201,216,785	EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$145,319,539	BOYAmt
EOY	$201,216,785	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$385,806,663	BOYAmt
EOY	$435,171,691	EOYAmt

Field	Value	IRS element (for citing)
Reconcilation Revenue Expnss	$55,897,246	ReconcilationRevenueExpnssAmt
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	false	AccountantCompileOrReviewInd
FS Audited	Yes (true)	FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

Field	Value	IRS element (for citing)
Consolidated Basis Fincl Stmt	Yes (X)	ConsolidatedBasisFinclStmtInd

Field	Value	IRS element (for citing)
Audit Committee	Yes (true)	AuditCommitteeInd
Federal Grant Audit Required	false	FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital	Yes (X)	HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

Field	Value	IRS element (for citing)
Contributor	RESTRICTED	ContributorNum

Contributor Business Name ContributorBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	RESTRICTED	BusinessNameLine1

Contributor US Address ContributorUSAddress

Field	Value	IRS element (for citing)
Address Line1	RESTRICTED	AddressLine1
Address Line2	RESTRICTED	AddressLine2
City	RESTRICTED	City
State	RESTRICTED	State
ZIP Code	RESTRICTED	ZIPCode

Field	Value	IRS element (for citing)
Total Contributions	RESTRICTED	TotalContributionsAmt

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Total Grassroots Lobbying		TotalGrassrootsLobbyingGrp
Total Direct Lobbying		TotalDirectLobbyingGrp
Total Lobbying Expend		TotalLobbyingExpendGrp
Other Exempt Purpose Expend		OtherExemptPurposeExpendGrp
Total Exempt Purpose Expend		TotalExemptPurposeExpendGrp
Lobbying Nontaxable Amount		LobbyingNontaxableAmountGrp
Grassroots Nontaxable		GrassrootsNontaxableGrp
Tot Lbbyng Grassroot Mns Non Tx		TotLbbyngGrassrootMnsNonTxGrp
Tot Lbby Expend Mns Lbbyng Non Tx		TotLbbyExpendMnsLbbyngNonTxGrp
Volunteers	false	VolunteersInd
Paid Staff Or Management	false	PaidStaffOrManagementInd
Media Advertisements	false	MediaAdvertisementsInd
Mailings Members	false	MailingsMembersInd
Publications Or Broadcast	false	PublicationsOrBroadcastInd
Grants Other Organizations	false	GrantsOtherOrganizationsInd
Direct Contact Legislators	false	DirectContactLegislatorsInd
Rallies Demonstrations	false	RalliesDemonstrationsInd
Other Activities	Yes (true)	OtherActivitiesInd
Other Activities	$7,402	OtherActivitiesAmt
Total Lobbying Expenditures	$7,402	TotalLobbyingExpendituresAmt
Not Described Section501c3	false	NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	Schedule C, Part II-B, Line 1i - Other Activities	FormAndLineReferenceDesc
Explanation	IU Health North Hospital paid institutional membership dues to the American Hospital Association ("AHA") and Indiana Hospital Association ("IHA") during 2016 in the amount of $26,389 and $20,010, respectively. Each membership organization notified IU Health North Hospital that a portion of the dues it paid were used for lobbying purposes. The AHA used 23.65%, or $6,241 of the 2016 membership dues paid by IU Health North Hospital, for lobbying expenditures. The IHA used 5.80%, or $1,161 of the 2016 membership dues paid by IU Health North Hospital, for lobbying expenditures. The total membership dues paid to these organizations by IU Health North Hospital during 2016 that were attributable to lobbying expenditures was $7,402.	ExplanationTxt

Schedule D IRS990ScheduleD

Field	Value	IRS element (for citing)
Art Public Exhibition Amounts		ArtPublicExhibitionAmountsGrp
Held Works Art		HeldWorksArtGrp
CY Minus3 Yr Endwmt Fund		CYMinus3YrEndwmtFundGrp
CY Minus4 Yr Endwmt Fund		CYMinus4YrEndwmtFundGrp
Land		LandGrp

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$160,170,858	OtherCostOrOtherBasisAmt
Depreciation	$45,154,952	DepreciationAmt
Book Value	$115,015,906	BookValueAmt

Field	Value	IRS element (for citing)
Leasehold Improvements		LeaseholdImprovementsGrp

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$98,499,471	OtherCostOrOtherBasisAmt
Depreciation	$87,260,573	DepreciationAmt
Book Value	$11,238,898	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$12,065,736	OtherCostOrOtherBasisAmt
Depreciation	$4,285,085	DepreciationAmt
Book Value	$7,780,651	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$134,035,455	TotalBookValueLandBuildingsAmt
Federal Income Tax Liability	$0	FederalIncomeTaxLiabilityAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)

DescDesc	AmtAmt
INTERCOMPANY PAYABLES (NET)	$216,045,921
DUE TO THIRD-PARTY PAYORS	$985,871
SELF-INSURANCE LIABILITIES	$261,608
ACCRUED LOAN GUARANTEES	$878,114

Field	Value	IRS element (for citing)
Total Liability	$218,171,514	TotalLiabilityAmt
Footnote Text	Yes (X)	FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	Schedule D, Part X, Line 2 - FIN 48 (ASC 740) Footnote	FormAndLineReferenceDesc
Explanation	IU Health North Hospital is a subsidiary in Indiana University Health, Inc.'s ("IU Health") Consolidated Audited Financial Statements. The Internal Revenue Service (IRS) has determined that IU Health and certain of its affiliated entities are tax-exempt organizations as defined in Section 501(c)(3) of the Internal Revenue Code (IRC). IU Health and its tax-exempt affiliates are, however, subject to federal and state income taxes on unrelated business income under the provision of IRC Section 511. Deferred income taxes, which as of December 31, 2016 and 2015, have no net carrying value, reflect the net tax effect of temporary differences between the carrying amounts of assets and liabilities for financial reporting and the amount used for income tax purposes. As of December 31, 2016 and 2015, the Indiana University Health System had gross deferred tax assets of $116,490,000 and $79,469,000, respectively, primarily relating to net operating loss carryovers. Management determined that a full valuation allowance at both December 31, 2016 and 2015 was necessary to reduce the deferred tax assets to the amount that would more likely than not be realized. ASC Topic 740-10-50-3, Income Taxes: Disclosure, requires a valuation allowance to reduce the deferred tax assets reported if, based on the weight of the evidence, it is more likely than not that some portion or all of the deferred tax assets will not be realized. The change in valuation allowance for the current year is $37,021,000. At December 31, 2016, the Indiana University Health System has available net operating loss carryforwards of $291,226,000. These net operating losses will expire between 2018 and 2036. Certain subsidiaries of IU Health are taxable entities. The tax expense and liabilities of these subsidiaries are not material to the consolidated financial statements.	ExplanationTxt

Schedule G IRS990ScheduleG

Fundraising Event Information FundraisingEventInformationGrp

Field	Value	IRS element (for citing)
Event1	SEE PART IV	Event1Nm
Gross Receipts Event1	$45,246	GrossReceiptsEvent1Amt
Charitable Contri Event1	$14,816	CharitableContriEvent1Amt
Gross Revenue Event1	$30,430	GrossRevenueEvent1Amt
Non Cash Prizes Event1	$2,541	NonCashPrizesEvent1Amt
Rent Facility Costs Event1	$5,324	RentFacilityCostsEvent1Amt
Food And Beverage Event1	$1,683	FoodAndBeverageEvent1Amt
Other Events Total	0	OtherEventsTotalCnt
Gross Receipts Total	$45,246	GrossReceiptsTotalAmt
Charitable Contributions Tot	$14,816	CharitableContributionsTotAmt
Gross Revenue Total Events	$30,430	GrossRevenueTotalEventsAmt
Non Cash Prizes Total Events	$2,541	NonCashPrizesTotalEventsAmt
Rent Fclty Costs Total Events	$5,324	RentFcltyCostsTotalEventsAmt
Food And Beverage Total Events	$1,683	FoodAndBeverageTotalEventsAmt
Direct Expense Summary Events	$9,548	DirectExpenseSummaryEventsAmt
Net Income Summary	$20,882	NetIncomeSummaryAmt

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	Schedule G - Part II, Column (a) - Event Type	FormAndLineReferenceDesc
Explanation	3rd Annual Jason Black Memorial Golf Outing	ExplanationTxt

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Financial Assistance Policy	Yes (true)	FinancialAssistancePolicyInd
Written Policy	Yes (true)	WrittenPolicyInd
All Hospitals Policy	Yes (X)	AllHospitalsPolicyInd
FPG Reference Free Care	Yes (true)	FPGReferenceFreeCareInd
Percent200	Yes (X)	Percent200Ind
FPG Reference Discounted Care	false	FPGReferenceDiscountedCareInd
Free Care Medically Indigent	Yes (true)	FreeCareMedicallyIndigentInd
Financial Assistance Budget	Yes (true)	FinancialAssistanceBudgetInd
Expenses Exceed Budget	Yes (true)	ExpensesExceedBudgetInd
Unable To Provide Care	false	UnableToProvideCareInd
Annual Community Bnft Report	Yes (true)	AnnualCommunityBnftReportInd
Report Publically Available	Yes (true)	ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

Field	Value	IRS element (for citing)
Persons Served	1523	PersonsServedCnt
Total Community Benefit Expns	$1,871,665	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$1,871,665	NetCommunityBenefitExpnsAmt
Total Expense	0.01000	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Persons Served	6852	PersonsServedCnt
Total Community Benefit Expns	$26,480,550	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$16,036,652	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$10,443,898	NetCommunityBenefitExpnsAmt
Total Expense	0.05580	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Persons Served	8375	PersonsServedCnt
Total Community Benefit Expns	$28,352,215	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$16,036,652	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$12,315,563	NetCommunityBenefitExpnsAmt
Total Expense	0.06580	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Activities Or Programs	8	ActivitiesOrProgramsCnt
Persons Served	7196	PersonsServedCnt
Total Community Benefit Expns	$974,236	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$49,514	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$924,722	NetCommunityBenefitExpnsAmt
Total Expense	0.00490	TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

Field	Value	IRS element (for citing)
Activities Or Programs	2	ActivitiesOrProgramsCnt
Persons Served	182	PersonsServedCnt
Total Community Benefit Expns	$476,930	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$476,930	NetCommunityBenefitExpnsAmt
Total Expense	0.00250	TotalExpensePct

Research ResearchGrp

Field	Value	IRS element (for citing)
Activities Or Programs	1	ActivitiesOrProgramsCnt
Persons Served	6000	PersonsServedCnt
Total Community Benefit Expns	$4,033	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$4,033	NetCommunityBenefitExpnsAmt

Cash And In Kind Contributions CashAndInKindContributionsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	3	ActivitiesOrProgramsCnt
Persons Served	9849	PersonsServedCnt
Total Community Benefit Expns	$165,688	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$165,688	NetCommunityBenefitExpnsAmt
Total Expense	0.00090	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	14	ActivitiesOrProgramsCnt
Persons Served	23227	PersonsServedCnt
Total Community Benefit Expns	$1,620,887	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$49,514	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$1,571,373	NetCommunityBenefitExpnsAmt
Total Expense	0.00830	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	14	ActivitiesOrProgramsCnt
Persons Served	31602	PersonsServedCnt
Total Community Benefit Expns	$29,973,102	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$16,086,166	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$13,886,936	NetCommunityBenefitExpnsAmt
Total Expense	0.07410	TotalExpensePct

Community Support CommunitySupportGrp

Field	Value	IRS element (for citing)
Activities Or Programs	1	ActivitiesOrProgramsCnt
Persons Served	1500	PersonsServedCnt
Total Community Benefit Expns	$2,572	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$2,572	NetCommunityBenefitExpnsAmt

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Activities Or Programs	1	ActivitiesOrProgramsCnt
Persons Served	1500	PersonsServedCnt
Total Community Benefit Expns	$2,572	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$2,572	NetCommunityBenefitExpnsAmt

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	false	BadDebtExpenseReportedInd
Bad Debt Expense	$1,058,128	BadDebtExpenseAmt
Reimbursed By Medicare	$27,271,993	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$35,706,291	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	-$8,434,298	MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

Field	Value	IRS element (for citing)
Cost To Charge Ratio	Yes (X)	CostToChargeRatioInd

Field	Value	IRS element (for citing)
Written Debt Collection Policy	Yes (true)	WrittenDebtCollectionPolicyInd
Financial Assistance Prvsn	Yes (true)	FinancialAssistancePrvsnInd
Hospital Facilities	1	HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

Field	Value	IRS element (for citing)
Facility	1	FacilityNum

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	IU HEALTH NORTH HOSPITAL	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	11700 N MERIDIAN ST	AddressLine1Txt
City	CARMEL	CityNm
State Abbreviation	IN	StateAbbreviationCd
ZIP	46032	ZIPCd

Field	Value	IRS element (for citing)
Website Address	HTTP://IUHEALTH.ORG/NORTH/	WebsiteAddressTxt
State License	16-004171-1	StateLicenseNum
Licensed Hospital	Yes (X)	LicensedHospitalInd
General Medical And Surgical	Yes (X)	GeneralMedicalAndSurgicalInd
Childrens Hospital	Yes (X)	ChildrensHospitalInd
Teaching Hospital	Yes (X)	TeachingHospitalInd
Emergency Room24 Hrs	Yes (X)	EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	IU HEALTH NORTH HOSPITAL	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Facility	1	FacilityNum
First Licensed CY Or PY	false	FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY	false	TaxExemptHospitalCYOrPYInd
CHNA Conducted	Yes (true)	CHNAConductedInd
Community Definition	Yes (X)	CommunityDefinitionInd
Community Demographics	Yes (X)	CommunityDemographicsInd
Existing Resources	Yes (X)	ExistingResourcesInd
How Data Obtained	Yes (X)	HowDataObtainedInd
Community Health Needs	Yes (X)	CommunityHealthNeedsInd
Other Health Issues	Yes (X)	OtherHealthIssuesInd
Community Hlth Needs Id Process	Yes (X)	CommunityHlthNeedsIdProcessInd
Consulting Process	Yes (X)	ConsultingProcessInd
Prior CHNA Impact	Yes (X)	PriorCHNAImpactInd
CHNA Conducted	15	CHNAConductedYr
Take Into Account Others Input	Yes (true)	TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts	Yes (true)	CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts	false	CHNAConductedWithNonFcltsInd
CHNA Report Widely Available	Yes (true)	CHNAReportWidelyAvailableInd
Rpt Available On Own Website	Yes (X)	RptAvailableOnOwnWebsiteInd
Own Website URL	SEE PART V, SECTION C	OwnWebsiteURLTxt
Paper Copy Public Inspection	Yes (X)	PaperCopyPublicInspectionInd
Implementation Strategy Adopt	Yes (true)	ImplementationStrategyAdoptInd
Implementation Strategy Adpt	15	ImplementationStrategyAdptYr
Strategy Posted Website	Yes (true)	StrategyPostedWebsiteInd
Strategy Website URL	SEE PART V, SECTION C	StrategyWebsiteURLTxt
Organization Incur Excise Tax	false	OrganizationIncurExciseTaxInd
Elig Criteria Explained	Yes (true)	EligCriteriaExplainedInd
FPG Family Incm Lmt Free Dscnt	Yes (X)	FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care	200.	FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care	0.	FPGFamilyIncmLmtDscntCarePct
Income Level Criteria	Yes (X)	IncomeLevelCriteriaInd
Asset Level Criteria	Yes (X)	AssetLevelCriteriaInd
Medical Indigency Criteria	Yes (X)	MedicalIndigencyCriteriaInd
Insurance Status Criteria	Yes (X)	InsuranceStatusCriteriaInd
Residency Criteria	Yes (X)	ResidencyCriteriaInd
Other Criteria	Yes (X)	OtherCriteriaInd
Explained Basis	Yes (true)	ExplainedBasisInd
App Financial Asst Expln	Yes (true)	AppFinancialAsstExplnInd
Described Info	Yes (X)	DescribedInfoInd
Described Suprt Doc	Yes (X)	DescribedSuprtDocInd
Provided Hospital Contact	Yes (X)	ProvidedHospitalContactInd
Includes Publicity Measures	Yes (true)	IncludesPublicityMeasuresInd
FAP Available On Website	Yes (X)	FAPAvailableOnWebsiteInd
FAP Available On Website URL	SEE PART V, SECTION C	FAPAvailableOnWebsiteURLTxt
FAP App Available On Website	Yes (X)	FAPAppAvailableOnWebsiteInd
FAP App Available On Website URL	SEE PART V, SECTION C	FAPAppAvailableOnWebsiteURLTxt
FAP Summary On Website	Yes (X)	FAPSummaryOnWebsiteInd
FAP Summary On Website URL	SEE PART V, SECTION C	FAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No Charge	Yes (X)	FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No Chrg	Yes (X)	FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No Chrg	Yes (X)	FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill Display	Yes (X)	NotifiedFAPCopyBillDisplayInd
Communtity Notified FAP	Yes (X)	CommuntityNotifiedFAPInd
FAP Translated	Yes (X)	FAPTranslatedInd
Other Publicity	Yes (X)	OtherPublicityInd
FAP Actions On Nonpayment	Yes (true)	FAPActionsOnNonpaymentInd
Permit No Actions	Yes (X)	PermitNoActionsInd
Collection Activities	false	CollectionActivitiesInd
Provided Written Notice	Yes (X)	ProvidedWrittenNoticeInd
Made Effort Orally Notify	Yes (X)	MadeEffortOrallyNotifyInd
Processed FAP Application	Yes (X)	ProcessedFAPApplicationInd
Made Presumptive Elig Determ	Yes (X)	MadePresumptiveEligDetermInd
Nondis Emergency Care Policy	Yes (true)	NondisEmergencyCarePolicyInd
Look Back Medicare Private	Yes (X)	LookBackMedicarePrivateInd
Amounts Generally Billed	false	AmountsGenerallyBilledInd
Gross Charges	false	GrossChargesInd

Supplemental Information SupplementalInformationGrp (11 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Schedule H, Part V, Section B, Line 5 - Input from Community	In conjunction with other area hospitals, IU Health North Hospitals approach to gathering qualitative data for its CHNA consisted of a multi-component approach to identify and verify community health needs for the IU Health North service area. This included the following components: 1. Hosting one two-hour focus group with public health officials and community leaders in attendance to discuss the healthcare needs of the service area and what role IU Health North could play in addressing the identified needs. 2. Surveying the community at large through the hospitals website, with special emphasis to garner input from low income, uninsured, or minority groups. Local leaders with a stake in the communitys health were invited to attend a focus group session held at the Hamilton County Fairgrounds. Attendees from organizations such as, Aspire Indiana, Community Health Network, Community Health Behavioral Care, Noblesville Township Trustee, Partnership for a Healthy Hamilton County, Riverview Health, and Hamilton County Health Department among others participated in the focus group. To obtain a more complete picture of the factors that play into the IU Health North communitys health, input from local health leaders was gathered through a focus group session lasting two hours. IU Health facilitators mailed letters and emailed invites and made follow-up telephone calls inviting public health officials and community leaders to attend the focus group discussion, paying special attention to including organizations that represent the interest of low-income, minority and uninsured individuals. The goal of soliciting these leaders feedback was to gather insights into the quantitative data that may not be easily identified from the secondary statistical data alone. Upon arrival to the focus group, participants were asked to list their believed five prioritized health needs for the Hamilton County community. Each table was then asked to aggregate and rank their top five needs into a comprehensive list of identified needs to be further discussed later in the session by the group as a whole. Facilitators then lead a discussion to gain consensus as a group of the top five health needs in Hamilton County.
Schedule H, Part V, Section B, Line 6a - CHNA Conducted with Other Hosp.	IU Health North Hospital conducted its CHNA in conjunction and collaboration with IU Health Saxony Hospital. IU Health North Hospital and IU Health Saxony Hospital are both located in Hamilton County and serve a community with similar and overlapping health needs.
Schedule H, Part V, Section B, Line 7a - CHNA Website	A copy of IU Health North Hospitals CHNA is available on its website at the following URL: http://iuhealth.org/about-iu-health/in-the-community/
Schedule H, Part V, Section B, Line 10a - Implementation Strategy Website	A copy of IU Health North Hospitals CHNA implementation strategy is available on its website at the following URL: http://iuhealth.org/about-iu-health/in-the-community/
Schedule H, Part V, Section B, Line 11 - Addressing Identified Needs	IU Health North Hospital prioritized and determined which of the community health needs identified in its most recently conducted CHNA was most critical for it to address by using the Hanlon Method of prioritization. This method prioritizes identified needs based upon the prevalence and severity of the need and the effectiveness of interventions available to address the needs. Based upon the Hanlon Method of prioritization, IU Health North Hospital selected the following five needs to be addressed: - Access to Healthcare - Exercise, Nutrition & Weight - Behavioral Health - Older Adults & Aging - Transportation Access to Healthcare IU Health North Hospitals implementation strategy to address the identified need of Access to Healthcare includes the following: - Provide operational & programmatic funding to support Trinity Free Clinic and Heart and Soul Clinic - Provide free community health screenings at community events through community partnerships - Provide an IU Health individual solutions coordinator to help individuals and families register for HIP 2.0 or other Marketplace insurance - Continue working with and providing financial support for the Partnership for a Healthy Hamilton County - Explore partnership with the Carmel Fire Department and its community paramedicine program Exercise, Nutrition & Weight IU Health North Hospitals implementation strategy to address the identified need of Exercise, Nutrition & Weight includes the following: - Support local farmers markets and advocate for WIC/SNAP programming at affiliated markets - Provide healthy cooking demonstrations at farmers markets using local produce - Partner with local schools to provide additional fitness and nutrition resources and education (presentations by dietitians, pedometer/walking competition, walking/running clubs) - Explore Jump In via United Way for local school intervention - Explore and assist with development of Hamilton County Parks & Rec BeneFIT program - Partner with Fishers Parks & Rec Department - Support dance camp scholarships for Junior Civic Theatre Behavioral Health IU Health North Hospitals implementation strategy to address the identified need of Behavioral Health includes the following: - Explore opportunities to support/fund Aspire Indiana, Inc., Indiana Chapter of American Foundation for Suicide Prevention, Mental health America of Hamilton County - Explore opportunities to provide mental health awareness seminars and/or support groups in the community - Partner with Chaucies Place to offer community and staff education on preventing and recognizing child sexual abuse - Provide funding to Chaucies Place to further child sexual abuse prevention programming in Hamilton County - Explore appropriate partnerships with existing groups/agencies including the Substance Abuse Task Force, local law enforcement Older Adults & Aging IU Health North Hospitals implementation strategy to address the identified need of Older Adults & Aging includes the following: - Explore opportunities to support/fund Central Indiana Council on Aging (CICOA) in Hamilton County - Explore volunteer networks/organizations to support patient transportation strategies - Provide free balance screenings for older adults - Explore appropriate partnerships with existing groups/agencies Transportation IU Health North Hospitals implementation strategy to address the identified need of Transportation includes the following: - Participate in the Hamilton Transit Forum and Support the work of the group - Work with local agencies and organizations (Hamilton County Express, Janus Development) to explore opportunities to expand transportation services - As a large employer in the county, IU Health North and Saxony will provide funding and political support for transportation initiatives when appropriate Also, based upon the Hanlon Method of prioritization, the following identified community health needs were not chosen as one of the needs to be addressed: - Injury Prevention - Prenatal Health After completing a gap analysis, IU Health North Hospital determined that the severity of and lack of resources available to address the five needs chosen to be addressed outweighed the severity of and resources available to address the two needs not chosen.
Schedule H, Part V, Section B, Line 13b - Income Level Other than FPG	In addition to FPG, IU Health North Hospital may take into consideration a patients income and/or ability to pay in calculation of a financial assistance award.
Schedule H, Part V, Section B, Line 13h - Other FAP Factors	IU Health North Hospital takes into consideration several other factors in determining patient eligibility for financial assistance. These factors include the following: 1. IU Healths Individual Solutions Department Prior to seeking Financial Assistance under the FAP, all patients or their guarantors must consult with a member of IU Healths Individual Solutions department to determine if healthcare coverage may be obtained from a government insurance/assistance product or from the Health Insurance Exchange Marketplace. 2. Alternate Sources of Assistance When technically feasible, a patient will exhaust all other state and federal assistance programs prior to receiving an award from IU Health North Hospitals Financial Assistance Program. Patients who may be eligible for coverage under an applicable insurance policy, including, but not limited to, health, automobile, and homeowners, must exhaust all insurance benefits prior to receiving an award from IU Health North Hospitals Financial Assistance Program. This includes patients covered under their own policy and those who may be entitled to benefits from a third-party policy. Patients may be asked to show proof that such a claim was properly submitted to the proper insurance provider at the request of IU Health North Hospital. Eligible patients who receive medical care from IU Health North Hospital as a result of an injury proximately caused by a third party, and later receive a monetary settlement or award from said third party, may receive Financial Assistance for any outstanding balance not covered by the settlement or award to which IU Health North Hospital is entitled. In the event a Financial Assistance Award has already been granted in such circumstances, IU Health North Hospital reserves the right to reverse the award in an amount equal to the amount IU Health North Hospital would be entitled to receive had no Financial Assistance been awarded. 3. Alternate Methods of Eligibility Determination IU Health North Hospital will conduct a quarterly review of all accounts placed with a collection agency partner for a period of no less than one hundred and twenty (120) days after the account is eligible for an Extraordinary Collection Action ("ECA"). Said accounts may be eligible for assistance under the FAP based on the patients individual scoring criteria. To ensure all patients potentially eligible for Financial Assistance under the FAP may receive Financial Assistance, IU Health North Hospital will deem patients/guarantors to be presumptively eligible for Financial Assistance if they are found to be eligible for one of the following programs, received emergency or direct admit care, and satisfied his/her required co-pay/deductible: - Indiana Childrens Special Health Care Services - Medicaid - Healthy Indiana Plan - Patients who are awarded Hospital Presumptive Eligibility (HPE) - Enrolled in a state and/or federal program that verifies the patient's gross household income is less than or equal to 200% of the Federal Poverty Level 4. Additional Considerations Financial Assistance may be granted to a deceased patients account if said patient is found to have no estate. Additionally, IU Health North Hospital will deny or revoke Financial Assistance for any patient or guarantor who falsifies any portion of a Financial Assistance application. 5. Non-Emergent Services Down Payment Uninsured Patients presenting for scheduled or other non-emergent services will not be charged more than the Amounts Generally Billed ("AGB") AGB for their services. Patients will receive an estimated AGB cost of their care prior to IU Health North Hospital rendering the services and will be asked to pay a down-payment percentage of the AGB adjusted cost prior to receiving services. In the event a patient is unable to fulfill the down-payment, their service may be rescheduled for a later date as medically prudent and in accordance will all applicable federal and state laws and/or regulations. 6. Emergency Services Non-Refundable Deposit This section will be implemented with a strict adherence to EMTALA and IU Health Policy ADM 1.32, Screening and Transfer of Emergency or Unstable Patients. Amount of Non-Refundable Deposit All Uninsured Patients presenting for services at IU Health North Hospitals Emergency Department, via transfer from another hospital facility, or direct admission, will be responsible for a one-hundred dollar ($100.00) non-refundable deposit for services rendered. Patients/guarantors will be responsible for any copays and/or deductibles required by their plan prior to full Financial Assistance being applied. Uninsured Patients wishing to make an application for Financial Assistance greater than the AGB must fulfill their non-refundable deposit prior to IU Health North Hospital processing said application. Uninsured Patients making payments toward their outstanding non-refundable deposit balance will have said payments applied to their oldest application on file, if applicable.
Schedule H, Part V, Section B, Line 16a - FAP Website	A copy of IU Health North Hospitals FAP is available on the following website: http://iuhealth.org/patients/my-iu-health/pay-a-bill/financial-assistance/
Schedule H, Part V, Section B, Line 16b - FAP Application Website	A copy of IU Health North Hospitals FAP Application is available on the following website: http://iuhealth.org/patients/my-iu-health/pay-a-bill/financial-assistance/
Schedule H, Part V, Section B, Line 16c - FAP PLS Website	A plain language summary of the FAP, including translated copies, is available on the following website: http://iuhealth.org/patients/my-iu-health/pay-a-bill/financial-assistance/
Schedule H, Part V, Section B, Line 16j - Other Measures to Publicize	IU Health North Hospital takes several other measures to publicize its FAP within the community. These measures include the following: 1. Conspicuous public displays will be posted in appropriate acute care settings such as the emergency department and registration areas describing the available assistance and directing eligible patients to the Financial Assistance Application. 2. IU Health North Hospital will include a conspicuous written notice on all patient billing statements that notifies the patient about the availability of this Policy, and the telephone number of its Customer Service Department which can assist patients with any questions they may have regarding this Policy. 3. IU Health Customer Service representatives will be available via telephone Monday through Friday, excluding major holidays, from 8:00 a.m. to 7:00 p.m. Eastern Time to address questions related to this Policy. 4. IU Health North Hospital will broadly communicate this Policy as part of its general outreach efforts. 5. IU Health North Hospital will educate its patient facing team members of the FAP and the process for referring patients to the Program.

Field	Value	IRS element (for citing)
Facility	4	FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (4 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	FacilityFacilityTxt
IU HEALTH NORTH REHABILITATION SERVICES
14645 HAZEL DELL RD STE 110	NOBLESVILLE	IN	46062	DIAGNOSTIC AND OTHER OUTPATIENT
IU HEALTH NORTH RADIOLOGY
200 W 103RD ST	INDIANAPOLIS	IN	46290	DIAGNOSTIC AND OTHER OUTPATIENT
IU HEALTH NORTH HOSP RADIOLOGY-FISHERS
10995 ALLISONVILLE RD STE 100B	FISHERS	IN	46038	DIAGNOSTIC AND OTHER OUTPATIENT
IU HEALTH ZIONSVILLE PHYSICAL THERAPY
6866 W STONEGATE DR STE 106	ZIONSVILLE	IN	46077	DIAGNOSTIC AND OTHER OUTPATIENT

Supplemental Information Detail SupplementalInformationDetail (15 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Schedule H, Part I, Line 3c - Other Factors Used in Determining Elig.	IU Health North Hospital uses several factors other than Federal Poverty Guidelines ("FPGs") in determining eligibility for free care under its FAP. These factors include the following: 1. Indiana Residency Requirement Financial Assistance will only be made available to residents of the State of Indiana and those eligible for assistance under 42 U.S.C.A. 1396b(v). IU Health North Hospital will employ the same residency test as set forth in Indiana Code 6-3-1-12 to define an Indiana resident. The term Resident includes any individual who was domiciled in Indiana during the taxable year, or any individual who maintains a permanent place of residence in Indiana and spends more than one hundred eight-three (183) days of the taxable year in Indiana. Patients residing in the state of Indiana while attending an institution of higher education may be eligible for assistance under the FAP if they meet the aforementioned residency test and are not claimed as a dependent on a parents or guardians federal income tax return. 2. IU Healths Individual Solutions Department Prior to seeking Financial Assistance under the FAP, all patients or their guarantors must consult with a member of IU Healths Individual Solutions department to determine if healthcare coverage may be obtained from a government insurance/assistance product or from the Health Insurance Exchange Marketplace. 3. Uninsured Patients All Uninsured Patients presenting for services at IU health North Hospital eligible under the FAP will not be charged more than the AGB as described in the FAP. 4. Services Rendered by Individual Providers The FAP does not cover services rendered by individual providers. A full listing of providers and services not covered by the FAP is available at www.iuhealth.org/financialassistance and is updated on a quarterly basis. 5. Alternate Sources of Assistance When technically feasible, a patient will exhaust all other state and federal assistance programs prior to receiving an award from IU Health North Hospitals Financial Assistance Program. Patients who may be eligible for coverage under an applicable insurance policy, including, but not limited to, health, automobile, and homeowners, must exhaust all insurance benefits prior to receiving an award from IU Health North Hospitals Financial Assistance Program. This includes patients covered under their own policy and those who may be entitled to benefits from a third-party policy. Patients may be asked to show proof that such a claim was properly submitted to the proper insurance provider at the request of IU Health North Hospital. Eligible patients who receive medical care from IU Health North Hospital as a result of an injury proximately caused by a third party, and later receive a monetary settlement or award from said third party, may receive Financial Assistance for any outstanding balance not covered by the settlement or award to which IU Health North Hospital is entitled. In the event a Financial Assistance Award has already been granted in such circumstances, IU Health North Hospital reserves the right to reverse the award in an amount equal to the amount IU Health North Hospital would be entitled to receive had no Financial Assistance been awarded. 6. Alternate Methods of Eligibility Determination IU Health North Hospital will conduct a quarterly review of all accounts placed with a collection agency partner for a period of no less than one hundred and twenty (120) days after the account is eligible for an ECA. Said accounts may be eligible for assistance under the FAP based on the patients individual scoring criteria. To ensure all patients potentially eligible for Financial Assistance under the FAP may receive Financial Assistance, IU Health North Hospital will deem patients/guarantors to be presumptively eligible for Financial Assistance if they are found to be eligible for one of the following programs, received emergency or direct admit care, and satisfied his/her required co-pay/deductible: - Indiana Childrens Special Health Care Services - Medicaid - Healthy Indiana Plan - Patients who are awarded Hospital Presumptive Eligibility (HPE) - Enrolled in a state and/or federal program that verifies the patient's gross household income is less than or equal to 200% of the Federal Poverty Level 7. Additional Considerations Financial Assistance may be granted to a deceased patients account if said patient is found to have no estate. Additionally, IU Health North Hospital will deny or revoke Financial Assistance for any patient or guarantor who falsifies any portion of a Financial Assistance application. 8. Patient Assets IU Health North Hospital may consider patient/guarantor Assets in the calculation of a patient's true financial burden. A patient's/guarantor's primary residence and one (1) motor vehicle will be exempted from consideration in most cases. A patient's primary residence is defined as the patient's principal place of residence and will be excluded from a patient's extraordinary asset calculation so long as the patient's equity is less than five-hundred thousand dollars ($500,000) and the home is occupied by the patient/guarantor, patient's/guarantor's spouse or child under twenty-one (21) years of age. One (1) motor vehicle may be excluded as long as the patient's equity in the vehicle is less than fifty-thousand dollars ($50,000). IU Health North Hospital reserves the right to request a list of all property owned by the patient/guarantor and adjust a patient's award of Financial Assistance if the patient demonstrates a claim or clear title to any extraordinary Asset not excluded from consideration under the above guidance. 9. Non-Emergent Services Down Payment Uninsured Patients presenting for scheduled or other non-emergent services will not be charged more than the AGB for their services. Patients will receive an estimated AGB cost of their care prior to IU Health North Hospital rendering the services and will be asked to pay a down-payment percentage of the AGB adjusted cost prior to receiving services. In the event a patient is unable to fulfill the down-payment, their service may be rescheduled for a later date as medically prudent and in accordance will all applicable federal and state laws and/or regulations. 10. Emergency Services Non-Refundable Deposit This section will be implemented with a strict adherence to EMTALA and IU Health Policy ADM 1.32, Screening and Transfer of Emergency or Unstable Patients. Amount of Non-Refundable Deposit All Uninsured Patients presenting for services at IU Health North Hospitals Emergency Department, via transfer from another hospital facility, or direct admission, will be responsible for a one-hundred dollar ($100.00) non-refundable deposit for services rendered. Patients/guarantors will be responsible for any copays and/or deductibles required by their plan prior to full Financial Assistance being applied. Uninsured Patients wishing to make an application for Financial Assistance greater than the AGB must fulfill their non-refundable deposit prior to IU Health North Hospital processing said application. Uninsured Patients making payments toward their outstanding non-refundable deposit balance will have said payments applied to their oldest application on file, if applicable.
Schedule H, Part I, Line 6a - C.B. Report Prepared by a Related Org.	IU Health North Hospitals community benefit and other investments, encompassing its total community investment, are included in the IU Health Community Benefit Report which is prepared on behalf of and includes IU Health and its related hospital entities in the State of Indiana. The IU Health Community Benefit Report is made available to the public on IU Healths website at http://iuhealth.org/about-iu-health/in-the-community/community-benefit-rep ort//. The IU Health Community Benefit Report is also distributed to numerous key organizations throughout the State of Indiana in order to broadly share the IU Health Statewide Systems community benefit efforts. It is also available by request through the Indiana State Department of Health or IU Health.
Schedule H, Part I, Line 7, Column (c) - Total Community Benefit Expense	Schedule H, Part I, Line 7, Column (f), Percent of Total Expense, is based on column (e) Net Community Benefit Expense. The percent of total expense based on column (c) Total Community Benefit Expense, which excludes direct offsetting revenue, is 16.01%.
Schedule H, Part I, Line 7, Column (f) - Percent of Total Expense	The amount of bad debt expense subtracted for purposes of calculating the percentage of total expense on Line 7, column (f) is $3,989,925.
Schedule H, Part II - Promotion of Health in Communities Served	IU Health North Hospital is part of the IU Health Statewide System. The IU Health Statewide System participates in a variety of community-building activities that address the social determinants of health in the communities it serves through investments in economic development efforts across the state, collaboration with like-minded organizations through coalitions that address key issues, and advocacy for improvements in the health status of vulnerable populations. This includes making contributions to community-building activities by providing investments and resources to local community initiatives that addressed economic development, community support and workforce development. Several examples include IU Healths support of the following organizations and initiatives that focus on some of the root causes of health issues, such as lack of education, employment and poverty: - Partnership for a Healthy Hamilton County - Aspire Indiana, Inc. - Starfish Initiative - Early Learning Indiana - United Way Additionally, through the IU Health Statewide Systems team member community benefit service program, "Strength That Cares", team members across the state make a difference in the lives of thousands of Hoosiers every year.
Schedule H, Part III, Line 2 - Bad Debt Expense Methodology	The amount reported on line 2 as bad debt is reported at cost, as calculated using the cost to charge ratio methodology.
Schedule H, Part III, Line 4 - Bad Debt Expense	IU Health North Hospital is a subsidiary in the consolidated financial statements of IU Health. IU Healths bad debt expense footnote is as follows: The Indiana University Health System does not require collateral or other security for the delivery of health care services from its patients, substantially all of whom are residents of the state of Indiana. However, assignment of benefit payments payable under patients health insurance programs and plans (e.g., Medicare, Medicaid, health maintenance organizations, and commercial insurance policies) is routinely obtained, consistent with industry practice. The provision for uncollectible accounts, for all payers, is recognized when services are provided based upon managements assessment of historical and expected net collections, taking into consideration business and economic conditions, changes and trends in health care coverage, and other collection indicators. Periodically, management assesses the adequacy of the allowance for uncollectible accounts based upon accounts receivable payer composition and aging, the significance of individual payers to outstanding accounts receivable balances, and historical write-off experience by payer category, as adjusted for collection indicators. The results of this review are then used to make any modifications to the provision for uncollectible accounts and the allowance for uncollectible accounts. In addition, the Indiana University Health System follows established guidelines for placing certain past-due patient balances with collection agencies. Patient accounts that are uncollected, including those placed with collection agencies, are initially charged against the allowance for uncollectible accounts in accordance with collection policies of the Indiana University Health System and, in certain cases, are reclassified to charity care if deemed to otherwise meet financial assistance policies of the Indiana University Health System.
Schedule H, Part III, Line 8 - Medicare Shortfall	The amount reported on Schedule H, Part III, Line 6 is calculated, in accordance with the Form 990 instructions, using "allowable costs" from IU Health North Hospitals Medicare Cost Report. "Allowable costs" for Medicare Cost Report purposes, however, are not reflective of all costs associated with IU Health North Hospitals participation in Medicare programs. For example, the Medicare Cost Report excludes certain costs such as billed physician services, the costs of Medicare Parts C and D, fee schedule reimbursed services, and durable medical equipment services. Inclusion of all costs associated with IU Health Norths participation in Medicare programs would significantly increase the Medicare shortfall reported on Schedule H, Part III, Line 7. IU Health North Hospital's Medicare shortfall is attributable to reimbursements that are less than the cost of providing patient care and services to Medicare beneficiaries and does not include any amounts that result from inefficiencies or poor management. IU Health North Hospital accepts all Medicare patients knowing that there may be shortfalls; therefore it has taken the position that any shortfall should be counted as part of its community benefit. Additionally, it is implied in Internal Revenue Service Revenue Ruling 69-545 that treating Medicare patients is a community benefit. Revenue Ruling 69-545, which established the community benefit standard for nonprofit hospitals, states that if a hospital serves patients with governmental health benefits, including Medicare, then this is an indication that the hospital operates to promote the health of the community.
Schedule H, Part III, Line 9b - Written Debt Collection Policy	IU Health North Hospitals FAP and Written Debt Collection Policy describe the collection practices applicable to patients, including those who may qualify for financial assistance. 1. Financial Assistance Application Patients or their guarantors wishing to apply for Financial Assistance are encouraged to submit a Financial Assistance Application within ninety (90) days of their discharge. Patients or their guarantors may submit an application up to two-hundred and forty (240) days from the date of their first billing statement from IU Health, however, accounts may be subject to ECA as soon as one hundred and twenty (120) days after having received their first billing statement. Patients or their guarantors submitting an incomplete application will receive written notification of the applications deficiency upon discovery by IU health. The application will be pended for a period of forty-five (45) days from the date the notification is mailed. IU Health will suspend any ECA until the application is complete, or the patient fails to cure any deficiencies in their application in the allotted period. Patients with limited English proficiency may request to have a copy of the FAP, a FAP Application, and FAP Plain Language Summary in one of the below languages: - Arabic - Burmese - Burmese-Falam - Burmese-Hakha Chin - Mandarin/Chinese - Spanish The patient, and/or their representative, such as the patients physician, family members, legal counsel, community or religious groups, social services or hospital personnel may request a FAP Application to be mailed to a patients primary mailing address free of charge. IU Health keeps all applications and supporting documentation confidential. Patients applying for assistance under the FAP will be required to complete a Financial Assistance Application. Patients must include the following documentation with their Financial Assistance Application: - All sources of Income for the last three (3) months; - Most recent three (3) months of pay stubs or Supplemental Security Income via Social Security; - Most recent three (3) statements from checking and savings accounts, certificates of deposit, stocks, bonds and money market accounts; - Most recent state and Federal Income Tax forms including schedules C, D, E, and F. In the event a patients and/or guarantors income does not warrant the filing of a federal tax return, the patient may submit a notarized affidavit attesting to the foregoing; - Most recent W-2 statement; - For patients or members of the Household who are currently unemployed, Wage Inquiry from WorkOne; and - If applicable, divorce/dissolution decrees and child custody order 2. Eligibility Determination IU Health North Hospital will inform patients or guarantors of the results of their application by providing the patient or guarantor with a Financial Assistance Determination within ninety (90) days of receiving a completed Application and all requested documentation. If a patient or guarantor is granted less than full charity assistance and the patient or guarantor provides additional information for reconsideration, IU Health Revenue Cycle Services may amend a prior Financial Assistance Determination. If a patient or guarantor seeks to appeal the Financial Assistance Determination further, a written request must be submitted, along with the supporting documentation, to the Financial Assistance Committee for additional review/reconsideration. All decisions of the Financial Assistance Committee are final. A patients Financial Assistance Application and eligibility determination are specific to each individual date(s) of service and related encounters. 3. Extraordinary Collection Actions IU Health North Hospital may refer delinquent patient accounts to a third-party collection agency after utilizing reasonable efforts to determine a patients eligibility for assistance under the FAP. IU Health and its third-party collection agencies may initiate ECA against a patient or their guarantor in accordance with this Policy and 26 C.F.R. 1.501(r). Said ECA may include the following: - Selling a patients or their guarantors outstanding financial responsibility to a third party. - Reporting adverse information about the patient or their guarantor to consumer credit reporting agencies or credit bureaus. - Deferring or denying, or requiring a payment before providing, medically necessary care because of a patients or their guarantors nonpayment of one or more bills for previously provided care covered under the FAP. - Actions requiring a legal or judicial process, including but not limited to placing a lien on patients or their guarantors property, foreclosing on a patients or their guarantors real property attaching or seizing a patients or their guarantors bank account or other personal property, commencing a civil action against a patient or their guarantor, causing a patient or guarantors arrest, causing a patient and/or guarantor to be subject to a writ of body attachment, and garnishing a patient or guarantors wages. When it is necessary to engage in such action, IU Health North Hospital and its third party collection agencies, will engage in fair, respectful and transparent collections activities. Patients or guarantors currently subject to an ECA who have not previously applied for Financial Assistance may apply for assistance up to two-hundred and forty (240) days of the date of their first billing statement from IU Health. IU Health and their third-party collection agencies will suspend any ECA engaged on a patient or their guarantor while an Application is being processed and considered. 4. Refunds Patients eligible for assistance under the FAP who remitted payment to IU Health North Hospital in excess of their patient responsibility will be alerted to the overpayment as promptly after discovery as is reasonable given the nature of the overpayment. Patients with an outstanding account balance on a separate account not eligible for assistance under the FAP will have their refund applied to the outstanding balance. Patients without an outstanding account balance described above will be issued a refund check for their overpayment as soon as technically feasible.
Schedule H, Part VI, Line 2 - Needs Assessment	Communities are multifaceted and so are their health needs. IU Health North Hospital understands that the health of individuals and communities are shaped by various social and environmental factors, along with health behaviors and additional influences. IU Health North Hospital assesses the health care needs of the communities it serves by conducting a CHNA. This assessment includes collaboration with other community organizations such as the Hamilton County Health Department, the Indiana State Department of Health, the Centers for Disease Control and Prevention and the United Way of Central Indiana. After completion of the CHNA, IU Health North Hospital reviewed the information gathered from community leader focus groups, community input surveys and statistical data. The needs identified were analyzed and ranked using the Hanlon method of prioritization to determine the prevalence and severity of community health needs and which ones were most critical. Additionally, the effectiveness of an intervention for each need and IU Health North Hospitals ability to impact positive change was evaluated.
Schedule H, Part VI, Line 3 - Patient Education of Eligibility for Assist.	IU Health North Hospital is committed to serving the healthcare needs of all of its patients regardless of their ability to pay for such services. To assist in meeting those needs, IU Health North Hospital has established a FAP to provide Financial Assistance to Uninsured Patients. IU Health North Hospital is committed to ensuring its patients are compliant with all provisions of the Patient Protection & Affordable Care Act. To that end, IU Health North Hospital will make a good faith effort to locate and obtain health insurance coverage for patients prior to considering patients for coverage under the FAP. IU Health North Hospital takes several measures to inform its patients of the FAP and FAP-eligibility. These measures include the following: 1. Conspicuous public displays will be posted in appropriate acute care settings such as the emergency department and registration areas describing the available assistance and directing eligible patients to the Financial Assistance Application. 2. IU Health North Hospital will include a conspicuous written notice on all patient billing statements that notifies the patient about the availability of this Policy, and the telephone number of its Customer Service Department which can assist patients with any questions they may have regarding this Policy. 3. IU Health Customer Service representatives will be available via telephone Monday through Friday, excluding major holidays, from 8:00 a.m. to 7:00 p.m. Eastern Time to address questions related to this Policy. 4. IU Health North Hospital will broadly communicate this Policy as part of its general outreach efforts. 5. IU Health North Hospital will educate its patient facing team members of the FAP and the process for referring patients to the Program.
Schedule H, Part VI, Line 4 - Community Information	IU Health North Hospital is located in Hamilton County, Indiana, a county located in central Indiana. Its service area counties include Marion, Hamilton, Boone, Hendricks, Hancock, Madison and Tipton counties. Hamilton County includes ZIP codes within the towns of Arcadia, Atlanta, Carmel, Cicero, Fishers, Noblesville, Sheridan, and Westfield. Based on the most recent Census Bureau (2016) statistics, Hamilton Countys population is 316,373 persons with approximately 51% being female and 49% male. The countys population estimates by race are 86.1% White, 3.8% Black, 3.6% Hispanic or Latino, 5.0% Asian, 0.2% American Indiana or Alaska Native, and 1.3% persons reporting two or more races. Hamilton County has relatively high level of educational attainment. A high school degree is the level of education 17% of Hamilton County residents have achieved. An additional 18% of Hamilton County residents had some college, but no degree. 42% of the Hamilton County population had an associates or bachelors degree, and 18% held a graduate or professional degree.
Schedule H, Part VI, Line 5 - Promotion of Community Health	During 2016, IU Health North Hospitals promotion of community health included the following highlights: - IU Health North Hospital has a strong presence across Indianapolis northern suburbs, and supports numerous not-for-profit and government agencies including schools, police and fire departments, and six chambers of commerce. - Partnered for a Healthy Hamilton County in conjunction with Community Health Network, Franciscan St. Francis Health Carmel, and St. Vincent Carmel. This group seeks to improve and maintain the health of all county residents. - IU Health North Hospital team members donate a great deal of time to community organizations through the system-wide "Strength that Cares" volunteer program. Currently, there are more than 200 team members at IU Health North Hospital participating in the program. - IU Health North Hospital is committed to its community and fostering the health of its residents and employees.
Schedule H, Part VI, Line 6 - Affiliated Health Care System	IU Health North Hospital is part of the IU Health Statewide System. The IU Health Statewide System is Indianas most comprehensive healthcare system. A unique partnership with the IU School of Medicine, one of the nations leading medical schools, gives patients access to innovative treatments and therapies. IU Health is comprised of hospitals, physicians and allied services dedicated to providing preeminent care throughout Indiana and beyond. National Recognition - Six hospitals designated as Magnet by the American Nurses Credentialing Center recognizing excellence in nursing care - Ten clinical programs ranked among the top 50 national programs in U.S. News & World Reports 2015-16 edition of Americas Best Hospitals - Ten out of ten specialty programs at Riley Hospital for Children at IU Health ranked among the top 50 childrens hospitals in the nation Education and Research As an academic health center, IU Health works in partnership with the IU School of Medicine to train physicians, blending breakthrough research and treatments with the highest quality of patient care. Each year, more than 1,000 residents and fellows receive training in IU Health hospitals. Research conducted by IU School of Medicine faculty gives IU Health physicians and patients access to the most leading-edge and comprehensive treatment options. In 2012, IU Health and the IU School of Medicine announced that they will invest $150 million over five years in the Strategic Research Initiative, a new research collaboration that will enhance the institutions joint capabilities in fundamental scientific investigation, translational research and clinical trials. The initial focus will be on projects in the fields of neuroscience, cancer and cardiovascular disease with the goal to fund transformative proposals that will fundamentally change our understanding of these diseases and lead to important new therapies for patients. The three target research areas represent research strengths at IU School of Medicine, key strategic service lines for IU Health, and important medical needs in a time of an aging population and rising healthcare costs: - Cancer: One of the initiative's primary goals is to enable the IU Health Melvin and Bren Simon Cancer Center to attain the National Cancer Institute's top status of "comprehensive," which would recognize it as one of the top-tier cancer centers in the national - Neuroscience: The neurosciences research program will tackle a broad range of brain injuries, neurodegenerative disorders and neurodevelopmental disorders - Cardiovascular: The cardiovascular research initiative will develop a comprehensive program for the study and treatment of heart failure, from newborns to older adults. A top priority is developing a cardiovascular genetics program The Strategic Research Initiative will provide patients with access to internationally renowned physicians and to new therapies developed through translational research and critical trials, and will make use of the latest genetic tools to develop personalized therapies that are more effective for individuals and efficient for healthcare providers. IU Health Statewide System IU Health is a part of the IU Health Statewide System which continues to broaden its reach and positive impact throughout the state of Indiana. IU Health is Indianas most comprehensive academic health center and consists of IU Health Methodist Hospital, IU Health University Hospital, Riley Hospital for Children at IU Health, and IU Health Saxony Hospital. Other hospitals in the IU Health Statewide System include the following: - IU Health Arnett Hospital - IU Health Ball Memorial Hospital - IU Health Bedford Hospital - IU Health Blackford Hospital - IU Health Bloomington Hospital - IU Health Goshen Hospital - IUHLP Liquidation, Inc. f/k/a IU Health La Porte Hospital - IU Health North Hospital - IU Health Paoli Hospital - IUHLP-SH, LLC f/k/a IU Health Starke Hospital - IU Health Tipton Hospital - IU Health West Hospital - IU Health White Memorial Hospital Although each hospital in the IU Health Statewide System prepares and submits its own community benefits plan relative to the local community, the IU Health Statewide System considers its community benefit plan as part of an overall vision for strengthening Indianas overall health. A comprehensive community outreach strategy and community benefit plan is in place that encompasses the academic medical center downtown Indianapolis, suburban Indianapolis and statewide entities around priority areas that focus on health improvement efforts statewide. IU Health is keenly aware of the positive impact it can have on the communities of need in the state of Indiana by focusing on the most pressing needs in a systematic and strategic way. Some ways we address our community health priorities as a system include: IU Health Day of Service The annual IU Health Day of Service is a high-impact event aimed at engaging IU Health team members in activities that address an identified community priority. Each year, more than 20,000 IU Health team member volunteer during the Day of Service. Community Health Initiatives With investments in high-quality and impactful initiatives to address community health needs statewide; IU Health is helping Indiana residents improve their health and their quality of life. In 2016, IU Health impacted many people statewide through presentations, health risk screenings, health education programs, and additional health educational opportunities made available to the community, especially to our community members in the greatest need of such services. Examples of the types of programming and investment we make in community outreach areas include: Access to Healthcare IU Health is committed to providing quality and complete healthcare for Hoosiers. Access to healthcare was a leading community health need identified in all communities served by IU Health across the state. IU Health is focusing on the needs of the underserved to create initiatives and support efforts that: - Educate community members to understand and navigate the healthcare system - Increase the availability of low-cost services and provide financial assistance. IU Health provides free or reduced-cost care and supports a number of clinics to provide free or reduced-cost care to individuals without access to insurance or the ability to pull the full cost of their healthcare. These clinics include: - IU Student Outreach Clinic - Hope Healthcare Services - Gennesaret Free Clinics - Trinity Free Clinic Healthy Weight & Nutrition Like most of the nation, Hoosiers see the alarming rise of obesity in their communities as a leading concern. Nationally, Indiana has the 15th highest adult obesity rate in the nation (The State of Obesity: Better Policies for a Healthier America, 2016). Obesity prevention was a critical community health need identified in IU Health communities across the state. IU Health is committed to launching innovative efforts aimed at preventing and reversing obesity in our communities to help community members get active, get health and get strong. IU Health is working to create initiatives and support efforts to: - Improve access to healthy foods - Create healthier school environments - Increase access to safe places for community members to be physically active IU Health initiatives aimed at preventing and reversing obesity in our communities include: - Strong Schools - Change the Play - My Healthy Habits App - Youth Diabetes Prevention Clinic Healthy Food Access Grant The Healthy Food Access Grant is an extension of the work started in 2011 with the Garden on the Go program to address obesity in the Indianapolis community. According to the USDA, between 25 and 30 million (9%) Americans are currently living in communities that do not provide adequate access to healthy food within a mile of their home. In Indianapolis, it is estimated that over 300,000 (36%) residents live in food deserts and have limited access to healthy and affordable food options. Indianapolis is reported as having the highest incidence of food deserts in the country (USDA, 2014). The lack of consumption and lack of access to healthy affordable food, particularly fresh produce, contributes to a poor diet and often can lead to higher rates of obesity and other diet-related diseases, such as diabetes and heart disease. Approximately 31% of Marion County residents are considered obese, up nearly 7% from 2010. When controlling for obesity, weight-related health problems, and health of environment, the Indianapolis area ranks among the worst metropolitan areas in the United States in terms of health. In sum, obesity is on the rise while increasingly more Indianapolis residents have less access to healthy and affordable food, which can contribute to lower consumption rates of fresh fruits and vegetables and higher rates of diet-related diseases. To address this important community and population health issue, IU Health
Schedule H, Part VI - Other	Disclosure in Accordance with Revenue Procedure 2015-21: In accordance with Revenue Procedure 2015-21, IU Health North Hospital discloses the following information with respect to Section 501(r) issues that were discovered during the 2016 tax year and how they have been corrected, to satisfy Section 501(r)(1) and 501(r)(2)(B) requirements. For all items: The cause was a good-faith effort by IU Health North Hospital to implement the requirements of the Section 501(r) regulations. IU Health North Hospital obtained information about the requirements and implemented them, though there were some gaps due to the detailed nature of the regulations. The issues were discovered in December 2016 when IU Health's System FAP, as applicable to IU Health North Hospital, was reviewed by the IRS as part of a courtesy review in conjunction with an audit of a tax-exempt organization related to IU Health North Hospital. The corrections were completed, in conjunction with the IRS courtesy review, in January 2017. The IRS confirmed in January 2017 that it believed IU Health's System FAP, effective January 2017, was in compliance with Section 501(r) and the Final Regulations. IU Health North Hospital has not identified any persons directly affected by these issues because the discrepancies related primarily to the specificity of information contained in the FAP. All individuals would have been in the same position. Specific Issues and Corrections: 1. Requirement: Inclusion of a Provider List Pursuant to Treas. Reg. 1.501(r)-4(b)(1)(iii)(F), a hospital facility's FAP is required to include a list of providers, other than the hospital facility itself, who are delivering emergency or other medically necessary care in the hospital facility and to be specific about which providers are covered by the hospital facility's FAP (and which are not). Pursuant to 5 of Notice 2015-46, a hospital facility's provider list is required to be updated "at least quarterly" in order for a hospital organization to be considered as having taken reasonable steps to ensure that its list is accurate. Condition: V.B.4.a of IU Health North Hospital's FAP, effective January 2016, stated that it "does not cover services rendered by individual providersthat a "full listing of providers and services not covered by this policy is available at www.iuhealth.org/financialassistance and is updated on a quarterly basis." During 2016, the IU Health North Hospital's Financial Assistance webpage contained a paragraph stating that a "complete list of all IU Health North Hospital providers not covered under IU Health North Hospital's FAP is available via the Find A Doctor page or as a PDF file." The "Find A Doctor page" allowed a search by first or last name of the provider. The result was a listing showing providers' pictures, specialties, and Hospitals & Affiliations. None of the information provided specifically identified whether a provider's services were or were not covered by IU Health North Hospital's FAP. The PDF file, entitled "Find A Doctor Printable Directory", did not specifically identify whose services were covered by IU Health North Hospital's FAP and whose were not. In addition, the listing was dated December 23, 2015 (almost one year old). These omissions led to the conclusion that IU Health North Hospital's FAP, effective January 2016, was not compliant with Treas. Reg. 1.501(r)-4(b)(1)(iii)(F) or Notice 2015-46. Corrective Action: IU Health North Hospital's Financial Assistance website at http://iuhealth.org/patients/my-iu-health/pay-a-bill/financial-assistance/ was updated in January 2017 to include the following information: "IU Health North Hospital's FAP does not cover individual physician charges. A listing of all providers who render services at an IU Health North Hospital facility and whose individual professional charges are not covered by this FAP, along with a list of any services that are not covered by this FAP, are available "herewas updated on December 31, 2016." By clicking "here" on the website, an individual was able to view a PDF file listing all individual physicians providing medical services at IU Health North Hospital with the specification that their services are not covered under IU Health North Hospital's FAP. Furthermore, IU Health North Hospital now updates the list no less frequently than quarterly. 2. Requirement: Description of Process and Time Frames Regarding FAP-eligibility and ECAs Pursuant to Treas. Reg. 1.501(r)-6(c), a hospital facility's FAP (or a separate written billing & collections policy) must describe the process and time frames that each hospital facility uses with respect to the reasonable efforts it will make to determine whether an individual is FAP eligible before engaging in any ECAs. Treas. Reg. 1.501(r)-6(c) defines two methods that will constitute reasonable efforts under paragraphs (c)(2) and (c)(3) as follows: - (c)(2): Presumptive FAP-eligibility determinations; and - (c)(3): Various, other efforts based on notification and processing of applications Condition: VI.D.1 of IU Health North Hospital's FAP, effective January 2016, provided that IU Health North Hospital may refer delinquent patient accounts to a third-party collection agency after utilizing "reasonable efforts" to determine a patient's eligibility for assistance under the FAP. VI.D.2 stated that IU Health North Hospital and its third-party collection agencies may initiate ECAs against a patient in accordance with the FAP and 26 CFR 1.501(r). The problem with this wording is that IU Health North Hospital did not describe the process and time frames that are involved with its "reasonable efforts". This omission led to the conclusion that IU Health North Hospital's FAP, effective January 2016, was not compliant with IRC 501(r)(4). Corrective Action: IU Health North Hospital added language to VI.D.1 and VI.D.2 of its FAP, effective January 2017, to fully describe the process and time frames that are involved with its reasonable efforts to determine a patient's eligibility for assistance under the FAP. 3. Requirement: Description of ECAs and Final Authority in Making Determinations Regarding FAP-eligibility and ECAs IRC 501(r)(4)(A)(iv) requires that a hospital facility's FAP address the actions that the organization may take in event of nonpayment. Treas. Rag 1.501(r)-(4)(b)(4)(C) requires that a hospital facility's FAP must describe the office, department, committee, or other body with the final authority or responsibility for determining that the hospital facility has made reasonable efforts to determine whether an individual is FAP-eligible and may engage in ECAs against the individual. Condition: IU Health North Hospital's FAP, effective January 2016, did not contain the required wording described above. This omission led to the conclusion that IU Health North Hospital FAP, effective January 2016, was not compliant with IRC 501(r)(4). Corrective Action: IU Health North Hospital added language to VI.D.2 through VI.D.4 of its FAP, effective January 2017, to fully describe the actions it may take in the event of nonpayment. Furthermore, IU Health North Hospital's Financial Assistance Committee is identified in IV of the FAP as the body responsible for the effectuation of the FAP including making final determinations if IU Health North Hospital had made reasonable efforts to determine a patient's eligibility for assistance under the FAP. 4. Requirement: Inclusion of a Facilities List Treas. Reg. 1.501(r)-4(d)(3) states that a hospital organization may establish a FAP (and B&CP and EMCP) that is shared with multiple hospital facilities provided that any joint policy clearly identifies each facility to which it applies. Condition: In II, "Scope," IU Health North Hospital's FAP, effective January 2016, stated that it "applies to all Uninsured Patients receiving care rendered at all non-profit IU Health hospital facilities, including those receiving emergent and/or medical necessary services." This language did not clearly identify each hospital facility, by name, to which it applied. Lacking this required language resulted in the conclusion that IU Health North Hospital's FAP, effective January 2016, was not compliant with IRC 501(r)(4). Corrective Action: IU Health North Hospital added language to VI.B.3 of its FAP, effective January 2017, to clearly identify each hospital facility, by name, to which it applied.

Schedule I IRS990ScheduleI

Field	Value	IRS element (for citing)
Grant Records Maintained	Yes (true)	GrantRecordsMaintainedInd

Recipient Table RecipientTable

Recipient Business Name RecipientBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	Methodist Health Foundation Inc	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1800 N Capital Ave	AddressLine1Txt
City	Indianapolis	CityNm
State Abbreviation	IN	StateAbbreviationCd
ZIP	46202	ZIPCd

Field	Value	IRS element (for citing)
Recipient EIN	356043086	RecipientEIN
IRC Section	501(c)(3)	IRCSectionDesc
Cash Grant	$85,000	CashGrantAmt
Valuation Method Used	N/A	ValuationMethodUsedDesc
Non Cash Assistance	N/A	NonCashAssistanceDesc
Purpose Of Grant	See Part IV	PurposeOfGrantTxt

Field	Value	IRS element (for citing)
Total501c3 Org	1	Total501c3OrgCnt
Total Other Org	0	TotalOtherOrgCnt

Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp

Field	Value	IRS element (for citing)
Grant Type	The Black Sisters Scholarship Fund	GrantTypeTxt
Recipient	3	RecipientCnt
Cash Grant	$8,987	CashGrantAmt
Valuation Method Used	N/A	ValuationMethodUsedDesc
Non Cash Assistance	N/A	NonCashAssistanceDesc

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Sch. I, Part I, Line 2 - Org.'s Proced. for Monit. the Use of Grant Funds	Although IU Health North Hospital does not monitor the use of grant funds once distributed, through due diligence the organization has reasonably confirmed that the entities to which the contributions are made are highly reputable in the community and use the funds for the purposes intended.
Schedule I, Part II, Line 1(H) - Purpose of Grant or Assistance	Grants and other assistance made to the Methodist Health Foundation were used for the establishment of the new IU Health North Professional Development Fund which will benefit IU Health North team members pursuing skills, training, certifications, and more to improve their patient care outcomes in their particular area or department.

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Severance Payment	false	SeverancePaymentInd
Supplemental Nonqual Rtr Plan	Yes (true)	SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm	false	EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org	false	CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs	false	CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org	false	CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs	false	CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments	Yes (true)	AnyNonFixedPaymentsInd
Initial Contract Exception	false	InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (20 entries)

TitleTitleTxt	Base Compensation Filing OrgBaseCompensationFilingOrgAmt	Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt	Bonus Filing OrganizationBonusFilingOrganizationAmount	Bonus Related OrganizationsBonusRelatedOrganizationsAmt	Other Compensation Filing OrgOtherCompensationFilingOrgAmt	Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt	Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt	Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt	Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt	Total Compensation Filing OrgTotalCompensationFilingOrgAmt	Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt	Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
JONATHAN R GOBLE
DIRECTOR/PRESIDENT & CEO	$0	$467,619	$0	$130,020	$0	$8,442	$0	$97,726	$0	$22,696	$0	$726,503	$0	$0
MICHAEL N TSANGARIS MD
DIRECTOR/PHYSICIAN (PART. YR.)	$4,500	$148,558	$0	$8,500	$0	$2,144	$0	$11,091	$0	$110	$4,500	$170,403	$0	$0
MATTHEW R COOK
DIRECTOR	$0	$384,373	$0	$252,305	$0	$15,624	$0	$82,948	$0	$11,483	$0	$746,733	$0	$0
DANIEL F EVANS JR
DIRECTOR	$0	$1,158,577	$0	$302,286	$0	$62,553	$0	$260,986	$0	$13,571	$0	$1,797,973	$0	$0
ADAM M HORST
DIRECTOR (PARTIAL YEAR)	$0	$279,401	$0	$55,600	$0	$18,478	$0	$13,250	$0	$8,600	$0	$375,329	$0	$0
MARK A LANTZY
DIRECTOR	$0	$328,740	$0	$57,500	$0	$22,783	$0	$74,904	$0	$24,723	$0	$508,650	$0	$0
STEVEN L WANTZ
DIRECTOR (PARTIAL YEAR)	$0	$421,340	$0	$198,683	$0	$26,824	$0	$92,494	$0	$22,736	$0	$762,077	$0	$0
JEROME P KELLY
SECRETARY (PARTIAL YEAR)	$0	$124,553	$0	$35,064	$0	$36,795	$0	$6,966	$0	$13,868	$0	$217,246	$0	$0
DEREK E EMPIE
SECRETARY	$0	$172,175	$0	$1,312	$0	$300	$0	$9,135	$0	$28,169	$0	$211,091	$0	$0
RANDALL C YUST
TREASURER/COO/CFO	$0	$250,376	$0	$38,071	$0	$21,623	$0	$13,250	$0	$19,328	$0	$342,648	$0	$0
PAUL M CALKINS MD
VP & CMO	$352,307	$0	$39,309	$0	$20,322	$0	$13,250	$0	$21,761	$0	$446,949	$0	$0	$0
SUZANNE M DELBOCCIO RN
VP & CNO (PARTIAL YEAR)	$178,324	$0	$27,654	$0	$9,969	$0	$9,497	$0	$7,735	$0	$233,179	$0	$0	$0
RUTH A KAIN RN
VP & CNO	$135,730	$0	$30,457	$0	$399	$0	$8,261	$0	$22,962	$0	$197,809	$0	$0	$0
SHELDON G WEISS MD
CHIEF STRATEGY OFFICER	$325,441	$0	$72,041	$0	$18,690	$0	$13,250	$0	$28,009	$0	$457,431	$0	$0	$0
MICHAEL L HARLOWE
PRESIDENT (TIPTON & SAXONY)	$233,105	$0	$42,132	$0	$1,189	$0	$10,757	$0	$21,320	$0	$308,503	$0	$0	$0
MARK A MCLEAN
DIRECTOR, OPERATIONS	$168,977	$0	$21,906	$0	$450	$0	$6,908	$0	$17,644	$0	$215,885	$0	$0	$0
LINDA S DECKER RN
TRANSFORMATION OFFICER	$179,538	$0	$2,767	$0	$792	$0	$8,951	$0	$7,996	$0	$200,044	$0	$0	$0
PAMELA V LOWE RN
DIRECTOR, QUALITY	$148,011	$0	$16,544	$0	$1,980	$0	$8,579	$0	$26,793	$0	$201,907	$0	$0	$0
CHARLES M SHUFFLEBARGER MD
FORMER PRESIDENT	$0	$331,068	$0	$24,942	$0	$4,278	$0	$17,225	$0	$258	$0	$377,771	$0	$0
ANN L ESKEW RN
FORMER DIRECTOR, RILEY-NORTH	$0	$117,101	$0	$3,126	$0	$1,528	$0	$4,583	$0	$9,381	$0	$135,719	$0	$0

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Schedule J, Part I, Line 3 - Comp. of the Org.'s CEO/Executive Director	IU Health North Hospitals President & CEO is employed by IU Health. IU Healths process for determining compensation includes the use of a compensation survey/study conducted by an independent compensation consultant with review and approval by the Committee on Personnel and Compensation and the Board of Directors. Please see Schedule O for additional details.
Schedule J, Part I, Line 4b - Supplemental Nonqualified Retirement Plan	Jonathan R. Goble, Matthew R. Cook, Daniel F. Evans, Jr., Mark A. Lantzy, and Steven L. Wantz participate in an IU Health supplemental executive retirement plan, provisions of which are designed to retain its critical employees. The plan provides for an additional retirement benefit for service through normal retirement or other key dates. If the executive leaves prior to retirement or other key dates, that benefit may be forfeited or reduced. Each of these executives has amounts included in column c, deferred compensation, representing the current year unvested contributions made under the supplemental retirement plan. No amounts were actually paid to these executives during the year.
Schedule J, Part I, Line 7 - Non-Fixed Payments	Amounts disclosed in Column B(ii) include a long-term and short-term incentive for certain executives and short-term incentive for other employees. Although these plans are based on a fixed formula that has been approved by the Board of Directors based upon certain qualitative and quantitative factors and goals, all discretionary incentive plans must be approved by the Board of Directors prior to any incentive payout.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (9 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Part VI, Section A, Line 1b - Number of Voting Members that are Indep.	IU Health North Hospital is part of a multi-entity hospital system controlled by IU Health, a 501(c)(3) tax-exempt organization whose board is comprised of voting members, of which substantially all are independent community members.
Part VI, Section A, Line 2 - Family or Business Relationships	Daniel F. Evans, Jr. and Michael L. Kubacki served on the board of directors of Lakeland Financial Corporation. Additionally, Michael L. Kubacki was an officer of Lakeland Financial Corporation.
Part VI, Section A, Lines 6, 7a and 7b - Members or Stockholders	Line 6: The sole member of IU Health North Hospital is IU Health, a 501(c)(3) tax-exempt organization. Line 7A: The Board of Directors of the IU Health North Hospital shall consist of up to twelve (12) voting members appointed by the IU Health, including up to five (5) directors who are members of the Medical Staff in good standing. Line 7B: The Board of Directors shall not, without the prior approval of the IU Health: - Authorize any merger, consolidation, reorganization, sale or transfer of all or substantially all of the assets of IU Health North Hospital; - Authorize any plan of dissolution of IU Health North Hospital, any liquidating distribution of the IU Health North Hospitals assets or other action related to the dissolution or liquidation of IU Health North Hospital; - Authorize any voluntary declaration of bankruptcy of IU Health North Hospital; - Amend, repeal, revise or adopt changes to the organizational documents of IU Health North Hospital; - Authorize the consolidation of any entity with, or acquisition of any entity by, IU Health North Hospital; - Authorize any agreement to act as primary obligor, or to serve as a guarantor, surety or co-obligor with respect to the indebtedness of any other party, to borrow amounts from third-party lenders or to loan money to any person or entity; - Authorize any pledge of, or grant any security interest or mortgage in, or otherwise encumber, any tangible assets in excess of an appropriate monetary threshold, other than in the ordinary course of business or pursuant to an approved budget or strategic plan; - Approve any management agreement for the management of all or a substantial part of IU Health North Hospitals operations; or - Authorize the establishment or acquisition by IU Health North Hospital of any subsidiaries, affiliates or joint venture arrangements or the acquisition by IU Health North Hospital of the stock or other equity interest or substantially all the assets of any other business or entity.
Part VI, Section A, Line 11b - Review of Form 990	The Treasurer/COO/CFO and Audit Committee reviewed and approved the Form 990. Following their review and approval, a complete copy of the Form 990 was made available to each board member prior to its filing. Each member was also informed of the availability of IU Healths Tax Department to answer any questions.
Part VI, Section B, Lines 12, 13, 14, and 16b - Policies	IU Health North Hospital is part of the IU Health system. As the sole member and controlling parent of IU Health North Hospital, IU Health and its Board of Directors have mandated that certain policies be followed to ensure greater standardization throughout the system. Thus, IU Health North Hospitals Board of Directors was not required to separately adopt a conflict of interest, whistleblower, document retention and destruction and joint venture policies because IU Healths Board of Directors had already adopted and required these policies to be followed by its subsidiaries.
Part VI, Section B, Line 12c - Conflict of Interest Policy	IU Health North Hospital follows IU Healths Conflict of Interest Policy. IU Healths Conflict of Interest Policy includes the following provisions: All IU Health employees, associates, colleagues and contracted personnel, including employed physicians and paid medical directors ("IU Health Representatives") are covered by and subject to its Conflict of Interest Policy. IU Health regularly and consistently monitors and enforces compliance with the policy through the following procedures: (a) On an annual basis, each IU Health Representative at the level of Manager or above, together with every other person designated by the Corporate Compliance Department ("Department"), must complete, sign and submit a Conflict of Interest Questionnaire ("Questionnaire") to the Department. Governing board members, committee members, corporate officers, medical staff and researchers must comply with the administrative requirements noted in the respective policies and procedures relative to those areas. (b) An IU Health Representative must supplement a Questionnaire in writing, if after completion of the original Questionnaire, a situation arises, or may reasonably be expected to arise, that would change any answer or information on the original Questionnaire if the situation had existed or been anticipated at the time of completion of the original Questionnaire. (c) If a fully and properly completed Questionnaire reveals facts or other information that might reasonably indicate a Conflict of Interest or violation of the policy, the IU Health Representative completing the questionnaire must secure approval by his/her supervisor, evidenced in writing. (d) The Department will review each Questionnaire and determine whether a Conflict of Interest exists and, if so, whether and how it should or may be eliminated, avoided or managed in order to comply with the spirit of the policy and with the best interests of IU Health and its patients. In making the determination, the Corporate Compliance Department may consult with the IU Health Representatives supervisor and other appropriate individuals and groups. (e) The scope of the policy is not limited to those who are required to complete Questionnaires. If an IU Health Representative is involved in a situation or relationship that would constitute a violation of the policy in the absence of disclosure and approval as described above, then the IU Health Representative must disclose the matter to his/her supervisor, secure his/her supervisors approval in writing, and disclose the matter to the Department. Otherwise, the IU Health Representative is in violation of the policy and subject to corrective action, up to and including termination. (f) The Chief Compliance Officer, in consultation with onsite Compliance personnel, may from time to time appoint standing or ad hoc committees to assist in resolving issues that arise under provisions of the policy.
Part VI, Section B, Line 15 - Process for Determining Compensation	IU Health North Hospitals President & CEO was employed during different portions of the year by IU Health North Hospital and IU Health. His compensation during both portions of the year was determined by IU Health. IU Healths process for determining compensation is as follows: (1) The Board of Directors has established a Committee on Personnel and Compensation. The individuals on this Committee are made up of individuals who are on the Board and who do not have a conflict of interest with IU Health. There are no physicians or employees on this Committee. This Committee develops and reviews annually the executive compensation philosophy, market analysis as to comparability and reasonableness. One of the purposes of this Committee is to review, approve and make recommendations regarding executive compensation and benefits to the IU Health Board. As deemed appropriate, this Committee also reviews the same detail with the Committee on Finance. The Committee on Finance is represented by certain members of the Board as well. (2) Each year the Committee on Personnel and Compensation engages an outside compensation consulting firm to conduct a compensation and benefits study for all senior vice presidents and above. The current compensation advisor is the Hay Group. Hay Group performs an independent compensation survey. The relevant comparability data includes: compensation and benefit levels paid by similarly situated organizations (both governmental and tax exempt) for functionally comparable positions as well as the availability of similar services in the geographic area. The Committee reviews the entire compensation package including: base compensation, short term and long term incentive plans, basic health and welfare benefits, qualified and nonqualified plans as well as any additional fringe benefits. Further, Hay Group will provide recommendations based upon the reasonable compensation information as it relates to salary increases, bonuses and benefits that are consistent with the compensation philosophy of the Committee. A separate analysis using the same methodology is done for the Chief Executive Officer. (3) The Committee reviews the salary survey and, if appropriate, makes recommendations on increases in salary and any changes in bonuses or benefits. The Committee's goal is to ensure that the total compensation and benefits package is reasonable based upon the independent data provided by Hay Group. The Committee votes on any changes in compensation or benefits. This review, discussion and vote are documented in the minutes for the meeting. There are no executives present during the final discussion and approval of compensation. (4) The Board reviews the report prepared by the Hay Group as well as the recommendations of the Committee on Personnel and Compensation as to changes in compensation approved by the Committee. As requested, the Committee on Finance also provides its review of recommendations on changes in executive compensation and benefits. This review, discussion and vote are documented in the minutes. (5) The Board then reviews the recommendations provided by the Committee on Personnel and Compensation and votes on the changes as well. No additional compensation or benefits are paid to the executives until the changes have been approved by the Committee and the Board. The discussion and approval are documented in the minutes of the meeting. There are no executives present during the final discussion and approval of compensation. The General Counsel prepares a formal written opinion reviewing the compensation and benefits approval process, comparing that process to the Intermediate Sanctions Test of IRC Section 4958 and, if the facts warrant, provides comments regarding the compensation and benefits approval process as this relates to meeting the requirements for a rebuttable presumption of reasonableness as provided in the Intermediate Sanctions Test. (6) After the end of each year, the Committee and Board also reviews the achievements of the executive group as it relates to the long-term and short-term shared and individual goals developed by the executive and the Board. These achievements may also be reviewed with the Committee on Finance. The Board, at its discretion, may approve bonus payments based upon the achievement of the goals and the compensation survey. The discussion and vote of the Committee and Board is documented in the minutes for each such meeting. The bonuses are not paid until approval is made by the Board. (7) The Committee on Personnel and Compensation and Audit Committee also review the required Form 990 disclosures related to executive compensation and benefits as well as compensation practices and approval processes prior to the filing of the Form 990 return with the Internal Revenue Service. IU Health North Hospital has a process in place to determine the compensation for the other officers and key employees. IU Health North Hospital uses an independent compensation consultant who utilizes a variety of methods and procedures to obtain compensation ranges for comparable officer and employee positions. The independent compensation consultant provides IU Health North Hospital with recommended compensation ranges for its officers and other employees, which are then used as a guide for setting reasonable compensation by management. Management decisions with regard to determining compensation are subject to the review and approval of the Compensation Committee and Board of Directors.
Part VI, Section C, Line 19 - Public Disclosure	IU Health North Hospitals Articles of Incorporation are available to the public through the Indiana Secretary of State's web-site. IU Health North Hospitals conflict of interest policy is described on Form 990, Schedule O. IU Health North Hospital is a consolidated subsidiary in the consolidated financial statements for IU Health. The consolidated financial statements for IU Health are available to the public through its bond filings.
FORM 990 PART IX LINE 11G	DESCRIPTION:SHARED SERVICES/PROF. FEES TOTAL FEES:41158725

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (42 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Exempt Code SectionExemptCodeSectionTxt	Public Charity StatusPublicCharityStatusTxt	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Controlled OrganizationControlledOrganizationInd
Clarian Transplant Institute Inc
950 N Meridian St Ste 800	Indianapolis	IN	46204	134350599	Healthcare	IN	501(c)(3)	10	IUH	Yes (true)
Goshen Health System Inc
200 High Park Ave	Goshen	IN	46527	351974765	Healthcare	IN	501(c)(3)	12 I	IUH	Yes (true)
Goshen Hospital Association Inc
200 High Park Ave	Goshen	IN	46527	356001540	Healthcare	IN	501(c)(3)	3	GHS	Yes (true)
HealthLINC Incorporated
950 N Meridian St Ste 800	Indianapolis	IN	46204	263571507	Healthcare	IN	501(c)(3)	10	IUHB	Yes (true)
Indiana Health Info Exchange Inc
846 N Senate Ave	Indianapolis	IN	46202	364550324	Healthcare	IN	501(c)(3)	12 I	NA	false
Indiana Radiology Partners Inc
950 N Meridian St Ste 800	Indianapolis	IN	46204	201017034	Healthcare	IN	501(c)(3)	10	IUH	Yes (true)
Indiana University Health Inc
950 N Meridian St Ste 300	Indianapolis	IN	46204	351955872	Healthcare	IN	501(c)(3)	3	NA	false
IU Health Arnett Foundation Inc
950 N Meridian St Ste 800	Indianapolis	IN	46204	356079797	Fundraising	IN	501(c)(3)	12 I	IUHA	Yes (true)
IU Health Arnett Inc
950 N Meridian St Ste 300	Indianapolis	IN	46204	263162145	Healthcare	IN	501(c)(3)	3	IUH	Yes (true)
IU Health Ball Memorial Hospital Inc
950 N Meridian St Ste 300	Indianapolis	IN	46204	350867958	Healthcare	IN	501(c)(3)	3	IUH	Yes (true)
IU Health Ball Memorial Physicians Inc
950 N Meridian St Ste 300	Indianapolis	IN	46204	351925641	Healthcare	IN	501(c)(3)	10	IUHBMH	Yes (true)
IU Health Bedford Inc
950 N Meridian St Ste 300	Indianapolis	IN	46204	237042323	Healthcare	IN	501(c)(3)	3	IUH	Yes (true)
IU Health Blackford Hospital Inc
950 N Meridian St Ste 300	Indianapolis	IN	46204	010646166	Healthcare	IN	501(c)(3)	3	IUHBMH	Yes (true)
IU Health Bloomington Inc
950 N Meridian St Ste 300	Indianapolis	IN	46204	351720796	Healthcare	IN	501(c)(3)	3	IUH	Yes (true)
IU Health BMH Foundation Inc
950 N Meridian St Ste 800	Indianapolis	IN	46204	311111784	Fundraising	IN	501(c)(3)	12 I	IUHBMH	Yes (true)
IU Health Care Associates Inc
950 N Meridian St Ste 300	Indianapolis	IN	46204	351747218	Healthcare	IN	501(c)(3)	10	IUH	Yes (true)
IU Health Goshen Foundation Inc
200 High Park Ave	Goshen	IN	46527	462565300	Fundraising	IN	501(c)(3)	12 I	GHS	Yes (true)
IUHLP Liquidation Inc
950 N Meridian St Ste 800	Indianapolis	IN	46204	351125434	Healthcare	IN	501(c)(3)	10	IUH	Yes (true)
IUHLP-P Liquidation Inc
950 N Meridian St Ste 800	Indianapolis	IN	46204	311070868	Healthcare	IN	501(c)(3)	10	IUHLP	Yes (true)
IU Health Morgan Inc
950 N Meridian St Ste 800	Indianapolis	IN	46204	273533027	Healthcare	IN	501(c)(3)	10	IUH	Yes (true)
IU Health Paoli Hosp Foundation Inc
950 N Meridian St Ste 800	Indianapolis	IN	46204	310992486	Fundraising	IN	501(c)(3)	10	IUHP	Yes (true)
IU Health Paoli Inc
950 N Meridian St Ste 300	Indianapolis	IN	46204	352090919	Healthcare	IN	501(c)(3)	3	IUHB	Yes (true)
IU Health Plans NFP Inc
950 N Meridian St Ste 800	Indianapolis	IN	46204	463803873	Insurance	IN	501(c)(4)	N/A	IUH	Yes (true)
IU Health Tipton Hospital Inc
950 N Meridian St Ste 300	Indianapolis	IN	46204	262772226	Healthcare	IN	501(c)(3)	3	IUH	Yes (true)
IU Health West Hospital Inc
950 N Meridian St Ste 300	Indianapolis	IN	46204	351814660	Healthcare	IN	501(c)(3)	3	IUH	Yes (true)
IU Health White Mem Hosp Fndtn Inc
PO Box 952	Monticello	IN	47960	351671806	Fundraising	IN	501(c)(3)	12 III-FI	IUHWMH	Yes (true)
IU Health White Memorial Hospital Inc
950 N Meridian St Ste 300	Indianapolis	IN	46204	273532963	Healthcare	IN	501(c)(3)	3	IUH	Yes (true)
IU Medical Group Foundation Inc
340 W 10th St No FS5100	Indianapolis	IN	46202	201093251	Fundraising	IN	501(c)(3)	12 II	NA	false
LaPorte Hospital Foundation Inc
PO Box 250	LaPorte	IN	46352	310952775	Fundraising	IN	501(c)(3)	12 I	NA	false
MDwise Marketplace Inc
1200 Madison Ave	Indianapolis	IN	46225	465270582	Insurance	IN	501(c)(4)	N/A	IUH	Yes (true)
MDwise Network Inc
1200 Madison Ave	Indianapolis	IN	46225	472619552	Insurance	IN	501(c)(4)	N/A	IUH	Yes (true)
Methodist Health Foundation Inc
1800 N Capitol Ave	Indianapolis	IN	46202	356043086	Fundraising	IN	501(c)(3)	12 I	IUH	Yes (true)
Methodist Health Group Inc
950 N Meridian St Ste 800	Indianapolis	IN	46204	350876390	Healthcare	IN	501(c)(3)	12 III-FI	NA	false
Methodist Medical Group Inc
950 N Meridian St Ste 800	Indianapolis	IN	46204	351945384	Healthcare	IN	501(c)(3)	3	IUH	Yes (true)
Methodist Occup Health Centers Inc
950 N Meridian St Ste 300	Indianapolis	IN	46204	351844176	Healthcare	IN	501(c)(3)	3	IUH	Yes (true)
Methodist Research Institute Inc
950 N Meridian St Ste 800	Indianapolis	IN	46204	352023710	Healthcare	IN	501(c)(3)	12 I	IUH	Yes (true)
MH Healthcare Inc
950 N Meridian St Ste 800	Indianapolis	IN	46204	351766531	Healthcare	IN	501(c)(3)	3	MMG	Yes (true)
Rehabilitation Hospital of Indiana Inc
4141 Shore Dr	Indianapolis	IN	46254	351786005	Healthcare	IN	501(c)(3)	3	MHH	Yes (true)
RHI Foundation Inc
4141 Shore Dr	Indianapolis	IN	46254	351932349	Fundraising	IN	501(c)(3)	12 I	RHI	Yes (true)
The Cheer Guild of Riley Hos for Child
705 Riley Hospital Dr	Indianapolis	IN	46202	356018517	Fundraising	IN	501(c)(3)	12 III-FI	NA	false
Tipton Co Health Care Foundation Inc
950 N Meridian St Ste 800	Indianapolis	IN	46204	311231905	Fundraising	IN	501(c)(3)	12 I	IUHTH	Yes (true)
University Family Physicians Inc
950 N Meridian St Ste 800	Indianapolis	IN	46204	237427350	Healthcare	IN	501(c)(3)	10	IUHCA	Yes (true)

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (23 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt
Ball Outpatient Sur Ctr LLC
569 Brookwood Village Ste 901	Birmingham	AL	35244	270275794	Healthcare	IN	NA
Beltway Surgery Centers LLC
569 Brookwood Village Ste 901	Birmingham	AL	35244	352072586	Healthcare	IN	NA
Bloomington Endo Center LLC
PO Box 550	Bloomington	IN	47402	352117943	Healthcare	IN	NA
BOSC Holdings LLC
950 N Meridian St Ste 800	Indianapolis	IN	46204	454147343	Healthcare	IN	NA
BSC Holdings LLC
950 N Meridian St Ste 800	Indianapolis	IN	46204	452314634	Healthcare	IN	NA
CHV Fund I LLC
950 N Meridian St Ste 800	Indianapolis	IN	46204	262523206	Venture Capital	IN	NA
CHV Fund II Management LLC
950 N Meridian St Ste 800	Indianapolis	IN	46204	371717823	Venture Capital	IN	NA
CHV Fund II LLC
950 N Meridian St Ste 800	Indianapolis	IN	46204	800902337	Venture Capital	IN	NA
CHV Fund Management LLC
950 N Meridian St Ste 800	Indianapolis	IN	46204	262523151	Venture Capital	IN	NA
Clarian Health Network LLC
950 N Meridian St Ste 800	Indianapolis	IN	46204	352055030	Healthcare	IN	NA
Eagle High Surg Center LLC
569 Brookwood Village Ste 901	Birmingham	AL	35244	352259204	Healthcare	IN	NA
EHSC Holdings LLC
950 N Meridian St Ste 800	Indianapolis	IN	46204	454147879	Healthcare	IN	NA
EWASC Holdings LLC
950 N Meridian St Ste 800	Indianapolis	IN	46204	473087761	Healthcare	IN	NA
Health Venture Management LLC
950 N Meridian St Ste 300	Indianapolis	IN	46204	205740218	Management	IN	NA
IEC Holdings LLC
950 N Meridian St Ste 800	Indianapolis	IN	46204	454148032	Healthcare	IN	NA
Indiana Endoscopy Centers LLC
569 Brookwood Village Ste 901	Birmingham	AL	35244	208398421	Healthcare	IN	NA
IUH EWA Surgery Ctr LLC
569 Brookwood Village Ste 901	Birmingham	AL	35244	473102482	Healthcare	IN	NA
IUH Saxony Surgery Ctr LLC
569 Brookwood Village Ste 901	Birmingham	AL	35244	275271091	Healthcare	IN	NA
ROC Surgery LLC
569 Brookwood Village Ste 901	Birmingham	AL	35244	271497960	Healthcare	IN	NA
ROCS Holdings LLC
950 N Meridian St Ste 800	Indianapolis	IN	46204	454148369	Healthcare	IN	NA
Senate St Surgery Center LLC
569 Brookwood Village Ste 901	Birmingham	AL	35244	421709357	Healthcare	IN	NA
SSC Holdings LLC
950 N Meridian St Ste 800	Indianapolis	IN	46204	464472887	Healthcare	IN	NA
SSSC Holdings LLC
950 N Meridian St Ste 800	Indianapolis	IN	46204	454148167	Healthcare	IN	NA

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (23 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Entity TypeEntityTypeTxt	Controlled OrganizationControlledOrganizationInd	Address Line1ForeignAddress/AddressLine1Txt	CityForeignAddress/CityNm	Province Or StateForeignAddress/ProvinceOrStateNm	CountryForeignAddress/CountryCd	Legal Domicile Foreign CountryLegalDomicileForeignCountryCd
BMH Medical Pavilion Association Inc
2525 W University Ave	Muncie	IN	47303	351858408	Condo Management	IN	NA	C	Yes (true)
Cardinal Health Ventures Inc
950 N Meridian St Ste 800	Indianapolis	IN	46204	351611424	Management	IN	NA	C	Yes (true)
CHV Capital Inc
950 N Meridian St Ste 800	Indianapolis	IN	46204	260752507	Venture Capital	IN	NA	C	Yes (true)
IU Health 457(B) Plan
1100 N Market St	Wilmington	DE	19890	476948347	Investments	IN	NA	T	Yes (true)
IU Health ACO Inc
950 N Meridian St Ste 800	Indianapolis	IN	46204	454421020	Healthcare	IN	NA	C	Yes (true)
IU Health Board Designated Trust
400 Howard St	San Francisco	CA	94105	306309021	Investments	IN	NA	T	Yes (true)
IU Health NTGI S&P500 Fund CF
PO Box 804358	Chicago	IL	60680	306298263	Investments	IN	NA	T	Yes (true)
IU Health Plans Holding Company Inc
950 N Meridian St Ste 800	Indianapolis	IN	46204	463794815	Insurance	IN	NA	C	Yes (true)
IU Health Plans Inc
950 N Meridian St Ste 800	Indianapolis	IN	46204	262127080	HMO	IN	NA	C	Yes (true)
IU Health Risk Purchasing Group Inc
151 Meeting St Ste 301	Charleston	SC	29401	260202446	Insurance	IN	NA	C	Yes (true)
IU Health Risk Retention Group Inc
151 Meeting St Ste 301	Charleston	SC	29401	201107674	Insurance	SC	NA	C	Yes (true)
IU Health Southern IN Physicians Inc
950 N Meridian St Ste 300	Indianapolis	IN	46204	351913875	Healthcare	IN	NA	C	Yes (true)
IUH Assurance SPC Ltd
				980395429	Insurance		NA	C	Yes (true)	PO Box 69 94 Solaris Ave	Camana Bay	Grand Cayman	CJ	CJ
Occ-Health Revenue Systems Inc
950 N Meridian St Ste 800	Indianapolis	IN	46204	203308057	Work Comp PPO	IN	NA	C	Yes (true)
Parkmor Drug Inc
1501 S Main St	Goshen	IN	46526	131394980	Pharmacy Sales	IN	NA	C	Yes (true)
PILR Inc
200 High Park Ave	Goshen	IN	46526	204294750	Development	IN	NA	C	Yes (true)
Proteuo Fund LP
				981075227	Investments		NA	C	Yes (true)	PO Box 31106 89 Nexus Way	Camana Bay	Grand Cayman	CJ	CJ
Radiation Oncology Resources Inc
200 High Park Ave	Goshen	IN	46526	262008424	Healthcare	IN	NA	C	Yes (true)
SCANS Inc
950 N Meridian St Ste 800	Indianapolis	IN	46204	453080392	Healthcare	IN	NA	C	Yes (true)
Univ Hlth (Shanghai) Mgt Con Co Ltd
					Management		NA	C	Yes (true)	88 Century Ave	Shanghai		CH	CH
University Health Management Inc
950 N Meridian St Ste 800	Indianapolis	IN	46204	272891143	Management	IN	NA	C	Yes (true)
University Health Mgmt (China) Inc
950 N Meridian St Ste 800	Indianapolis	IN	46204	273891311	Management	IN	NA	C	Yes (true)
IU Health Plans Insurance Company
950 N Meridian St Ste 800	Indianapolis	IN	46204	811097215	Insurance	IN	NA	C	Yes (true)

Field	Value	IRS element (for citing)
Receipt Of Int Annts Rnts Rylts	false	ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org	Yes (true)	GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org	false	GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org	false	LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org	Yes (true)	LoansOrGuaranteesFromOthOrgInd
Div Related Organization	false	DivRelatedOrganizationInd
Asset Sale To Other Org	false	AssetSaleToOtherOrgInd
Asset Purchase From Other Org	false	AssetPurchaseFromOtherOrgInd
Asset Exchange	false	AssetExchangeInd
Rental Of Facilities To Oth Org	Yes (true)	RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org	Yes (true)	RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org	Yes (true)	PerformOfServicesForOthOrgInd
Perform Of Services By Other Org	Yes (true)	PerformOfServicesByOtherOrgInd
Sharing Of Facilities	false	SharingOfFacilitiesInd
Paid Employees Sharing	Yes (true)	PaidEmployeesSharingInd
Reimbursement Paid To Other Org	false	ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org	false	ReimbursementPaidByOtherOrgInd
Transfer To Other Org	Yes (true)	TransferToOtherOrgInd
Transfer From Other Org	Yes (true)	TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (9 entries)

Transaction TypeTransactionTypeTxt	InvolvedInvolvedAmt	Method Of Amount DeterminationMethodOfAmountDeterminationTxt
Methodist Health Foundation Inc
B	$85,000	FMV
IU Health Care Associates Inc
J	$368,864	FMV
IU Health Care Associates Inc
L	$264,589	FMV
IU Health Care Asscociates Inc
M	$8,082,661	FMV
Methodist Occupational Health Centers Inc
M	$106,515	FMV
IU Health Care Associates Inc
O	$147,652	FMV
IU Health Tipton Hospital Inc
O	$740,919	FMV
IUH Assurance SPC Ltd
R	$429,840	FMV
IU Health Risk Retention Group Inc
R	$758,905	FMV